J Infect, 1990 Sep, 21(2), 143 - 50 A study of three blood culture media for isolating genital mycoplasmas from obstetrical and gynaecological patients; al-Zahawi MF et al.; Mycoplasma species are often found colonising the female genital tract . Their ability to become invasive and pathogenic, however, is often ignored, since attempts may not be made to culture these organisms from the bloodstream . We have investigated the ability of three types of blood culture media to support the growth of genital mycoplasmas . The media studied included brain-heart infusion broth, brain-heart infusion broth supplemented with 30% V/V sucrose and fastidious anaerobe broth . Genital mycoplasmas were cultured from the latter medium only . Since this was the sole medium which was liquoid-free, the inhibitory effects of liquoid on Mycoplasma spp . is discussed . This study comprised an investigation of 75 patients in obstetric and gynaecological wards with postpartum or post-operative fever . Genital mycoplasmas were isolated from five (6.7%) patients, four with Ureaplasma urealyticum and one with M . hominis . The value of considering these organisms in the differential diagnosis of fever in 'at risk' patients and of including appropriate media for their isolation is emphasised. Eur J Clin Microbiol Infect Dis, 1990 Sep, 9(9), 667 - 71 Evaluation of two media for antibiotic susceptibility testing of anaerobic bacteria using the receiver operating characteristic procedure; Castel O et al.; Wilkins-Chalgren agar and Meat-Yeast agar were evaluated as media for antibiotic susceptibility testing using 112 anaerobic bacterial strains . The results obtained with the two media using the diffusion method were compared with those obtained by the dilution method as reference method . The results were analyzed by the receiver operating characteristic (ROC) procedure allowing a graphic representation of sensitivity and specificity of the technique for each cut-off value . The area under the ROC curves was calculated to compare the accuracy of the two methods . Six antibiotics were tested including amoxicillin, cefoxitin, piperacillin, doxycycline and clindamycin . For amoxicillin and clindamycin, the two methods showed a high and identical discriminative power for distinguishing susceptible bacteria from the others . Diffusion in Wilkins-Chalgren agar appeared better than diffusion in Meat-Yeast agar for separating resistant bacteria from bacteria of intermediate susceptibility (amoxicillin p less than 0.005; clindamycin p less than 0.04) . For other drugs, diffusion in Wilkins-Chalgren agar always had a discriminative power higher than that obtained with diffusion in Meat-Yeast agar for separating susceptible bacteria from the others (cefoxitin p less than 0.0005; piperacillin p less than 0.02; doxycycline p less than 0.05) . The Wilkins-Chalgren agar medium thus appeared superior to the Meat-Yeast agar medium using the ROC evaluation method, which would deserve wider utilization in the field of microbiology. Infect Dis Clin North Am, 1990 Sep, 4(3), 539 - 50 Vertebral osteomyelitis; Sapico FL et al.; Vertebral osteomyelitis can be caused by a variety of microorganisms . The hematogenous pyogenic form is characteristically a disease of people over age 50, predominantly in the male population, and most frequently caused by S . aureus . In IVDAs, however, younger patients and a heavier predominance of males are seen, and P . aeruginosa is one of the most commonly seen pathogens . The disease is generally monomicrobial, unless it is secondary to a contiguous process such as a pressure sore, in which polymicrobial infection with participation of anaerobes is the general rule . Lumbar, greater than thoracic, greater than cervical involvement is the rule in the general population, but cervical spine involvement is frequently seen more often than thoracic involvement in IVDAs . Diabetic patients are over-represented among patients with vertebral osteomyelitis, and they also have a tendency for higher morbidity and mortality . Simultaneous involvement of adjacent vertebral end plates and the intervening disk is the general rule . The vertebrae are generally involved, and the posterior elements of the spine are involved infrequently . Posterior element involvement is seen more commonly in actinomycosis, coccidioidomycosis, and neoplasms . Newer diagnostic modalities, such as CT, MRI, and radionuclide scans, may detect the disease earlier than conventional radiographs . Immunobilization by bed rest and appropriate antimicrobial therapy are generally sufficient in the therapy of pyogenic, as well as tuberculous, vertebral osteomyelitis . In selected circumstances, such as in the presence of marked instability of the spine, the presence of new neurologic deficits, or with progression of previous neurologic deficits, surgical intervention may be necessary . With prompt diagnosis and proper management, the prognosis should generally be good. J Clin Periodontol, 1990 Sep, 17(8), 570 - 4 Microbiological and clinical effects of a dentifrice containing zinc citrate and Triclosan in the human experimental gingivitis model; Jones CL et al.; A partial mouth experimental gingivitis model was employed to establish the effect of a dentifrice containing 0.2% Triclosan and 0.5% zinc citrate on the development of chronic gingivitis . In addition, changes in the plaque flora associated with the developing gingivitis have been monitored . Following a period of stringent oral hygiene, volunteers were allocated to 1 of 2 treatment groups . A toothshield was constructed to fit 4 posterior mandibular teeth . During the 21-day experimental period test or placebo dentifrice was applied to the experimental teeth via the tooth shield . The toothshield also prevented plaque removal from those teeth during habitual brushing of the remaining dentition . Supragingival plaque was collected at baseline and day 21 for analysis of the total bacterial flora . At the end of the experimental period, plaque and gingivitis had developed in both groups . However, the test group had significantly less plaque and gingivitis than the placebo group . The microbiological data demonstrated that plaque from the test group contained significantly lower numbers of anaerobes compared to plaque from the placebo group . This was considered particularly significant as these bacteria are generally associated with chronic inflammatory periodontal disease . There was also a trend for the numbers of actinomyces to decrease in plaque from the test group but not in the placebo group. Arch Monaldi Mal Torace, 1990 Sep-Oct, 45(5), 401 - 10 {Cefotetan treatment of suppurative bronchopulmonary syndromes sustained by anaerobic germs}; Caputi M et al.; The Authors have analyzed the effect of Cefotetan in 20 patients affected by bronchopulmonary pathologies supported by anaerobic bacterium . During 7 days doses of 50 mg . pro Kg/pro die were given . From beginning to end of the treatment clinical, hematochemical and radiological data were evaluated . Bacteriological analysis was made on samples drawn with BFS according to a traditional method and with microbiology specimen brush . Almost all the patients (95%) realized improvements in clinical symptomatology and in radiological picture. Dtsch Z Mund Kiefer Gesichtschir, 1990 Sep-Oct, 14(5), 325 - 9 {Bacterial growth on carcinomas of the oral mucosa}; Liebermann B et al.; Carcinomas of the oral mucosa are colonized by a variety of aerobic and anaerobic bacteria . Apart from the normal flora of the oral cavity also organisms of pathogenic potential are found, which may cause postoperative wound infections . A specific antibiotic prophylaxis regimen in extensive head and neck surgery requires identification of the pathopotent organisms and sensitivity testing followed by perioperative individual antimicrobial chemoprophylaxis management . The results of an additional bacteriological examination of the surrounding pharyngeal flora showed no major difference to the range of organisms found in the carcinoma. Am J Obstet Gynecol, 1990 Sep, 163(3), 968 - 74 Amniotic fluid glucose concentration: a rapid and simple method for the detection of intraamniotic infection in preterm labor; Romero R et al.; The purpose of this study was to determine whether amniotic fluid glucose concentrations is of value in the rapid diagnosis of intraamniotic infection . Amniocenteses were performed in 168 patients with preterm labor and intact membranes . Amniotic fluid was cultured for aerobic and anaerobic bacteria, as well as Mycoplasma species . The prevalence of positive amniotic fluid cultures was 13.6% (23/168) . Patients with positive amniotic fluid cultures for microorganisms had significantly lower median amniotic fluid glucose concentrations than patients with negative amniotic fluid cultures (median 11 mg/dl, range 2 to 30 mg/dl vs median 28 mg/dl, range 3 to 74, respectively; p less than 0.001) . Amniotic fluid glucose concentrations below 14 mg/dl had a sensitivity of 86.9% (20/23), a specificity of 91.7% (133/145), a positive predictive value of 62.5% (20/32), and a negative predictive value of 97.8% (133/136) in the detection of a positive amniotic fluid culture . Amniotic fluid glucose determination is a rapid, sensitive, inexpensive, and simple test for the detection of intraamniotic infection in women with preterm labor and intact membranes. J Chromatogr, 1990 Aug 31, 515, 415 - 34 Applications of high-performance liquid chromatography in bacteriology . I . Determination of metabolites; Lucarelli C et al.; The chemotaxonomic approach to the identification of pathogenic bacteria for clinical purposes is surveyed . Primary interest is focused on the applications of HPLC to the determination of metabolic products from anaerobic bacteria . The use of HPLC is attractive as different classes of short-chain acids can be determined in a single analysis . Chromatographic conditions are extensively described, emphasizing the effects of changing variables on the HPLC profiles of analytes . The application of labelling procedures to bacterial metabolites can markedly increase the sensitivity of the analysis of pathological fluids . HPLC appears to be potentially useful in clinical bacteriology for the diagnosis of anaerobic infections. Biochem Biophys Res Commun, 1990 Aug 31, 171(1), 313 - 8 Purification and characterization of two proteins with inorganic pyrophosphatase activity from Desulfovibrio vulgaris: rubrerythrin and a new, highly active, enzyme; Liu MY et al.; The inorganic pyrophosphatase activity of a soluble extract from the strict anaerobe, sulfate-reducing, Desulfovibrio vulgaris, is readily resolved into two peaks . After purification, two active proteins with very dissimilar properties are obtained . One is the non-heme iron-containing rubrerythrin, with a specific activity of 350 pyrophosphate hydrolyzed, min-1, mg protein-1 . The other, a protein of Mr = 39,000, with a specific activity of 12,000. Postgrad Med, 1990 Aug, 88(2), 99 - 100, 103-5, 108 Peritonsillar abscess . Why aggressive management is appropriate; Petruzzelli GJ et al.; Peritonsillar abscess is the most common deep neck infection in adults . Infections develop from purulent material collecting in the fascial spaces lateral to the capsule of the palatine tonsil . Infections are usually polymicrobial, and a significant number of anaerobes are isolated . The cornerstone of therapy is drainage of the abscess . With cooperative patients, careful permucosal needle aspiration is an accepted method of primary therapy . Large or recurrent abscesses require otolaryngologic consultation for adequate incision and drainage . Tonsillectomy may be necessary to prevent re-formation of abscess in patients with a history of recurrent tonsillitis. Australas Radiol, 1990 Aug, 34(3), 256 - 9 Necrobacillosis; Adler J et al.; Necrobacillosis is a severe septicaemic illness caused by the gram negative anaerobe, Fusobacterium necrophorum, that typically occurs in previously healthy young adults following a mild sore throat . Radiological changes in the chest are prominent and include rapidly developing empyema, pneumonic consolidation, cavitation and pneumatocele formation . Metastatic abscesses in other sites are also seen . The clinical setting and time course are in marked contrast to the presentation of most anaerobic pleuro-pulmonary infections . Two cases are described, in one of which the outcome was fatal . Both displayed marked chest disease as an early manifestation of their illness . As the condition is relatively uncommon, radiological diagnosis demands a high index of suspicion in order to facilitate early treatment. Nippon Geka Gakkai Zasshi, 1990 Aug, 91(8), 972 - 9 {Preoperative oral antimicrobial bowel preparations in elective colorectal surgery}; Ono S et al.; Colorectal surgery is associated with high incidence of postoperative wound infection due to contamination of the field of operation by organisms from the intestine . A consecutive series of 300 patients undergoing elective operations on the colon and rectum, was studied to determine the efficacy of oral antibacterial preparations on the influence of intestinal organisms at operation and the incidence of postoperative wound infection . The patients were divided into four groups as their preoperative bowel preparations as follows; 1st group: mechanical preparation alone, 2nd group: mechanical preparation and oral kanamycin, 3rd group: mechanical preparation and oral kanamycin and metronidazole, and 4th group: mechanical preparation and oral polymyxin B and metronidazole . The results of bacteriological studies on specimens taken by swab from colonic lumen and wound at operation showed effectiveness of kanamycin and polymyxin B against aerobic gram-negative rods and metronidazole against anaerobes . The rates of postoperative wound infection were 47.5% in 1st group, 27% in 2nd group, 12% 3rd group, and 2.7% in 4th group, respectively. Biopharm Drug Dispos, 1990 Aug-Sep, 11(6), 465 - 75 Microbially controlled drug delivery to the colon; Rubinstein A; The human gastrointestinal tract consists of a highly complex ecosystem of aerobic and anaerobic microorganisms that plays a significant role in the metabolism of nutrients as well as drugs . In the colon, bacteria ferment various types of substrates that are not susceptible to digestion in the small intestine . This arouses interest in specific drugs, drug delivery systems, and prodrugs that escape small bowel digestion, arrive intact, and are absorbed or degraded in the large bowel . For the past forty years, experience has been gained with the azo prodrug of 5-amino salicylic acid, salazopyrine, which is cleaved by colonic bacteria to its parent drug . Some laxative drugs were also reported to degrade into active metabolites in the colon . Lately equally interesting and more sophisticated microbial controlled delivery systems, have been developed based on similar principles. Mil Med, 1990 Aug, 155(8), 345 - 7 The medical management of acute appendicitis in a nonsurgical environment: a retrospective case review; Adams ML; The treatment of acute appendicitis in remote environments without the capability of surgical intervention appears to be effective when using antibiotic protocols active against both aerobic and anaerobic bacteria . A review of nine such cases treated with various antibiotic protocols was conducted and demonstrated good response in all patients . This aggressive medical management frequently resulted in complete resolution of symptoms in patients who later required elective appendectomy or who had recurrences, with similar symptoms requiring acute appendectomies . A strong index of suspicion for appendicitis must be maintained in these cases and one must rely on the medical documentation of the initial episode and proceed with a thorough surgical evaluation. J Ind Microbiol, 1990 Aug, 5(6), 365 - 74 CP-60,993, a new dianemycin-like ionophore produced by Streptomyces hygroscopicus ATCC 39305: fermentation, isolation and characterization; Cullen WP et al.; CP-60,993, 19-epi-dianemycin, is a novel polycyclic ether antibiotic produced by Streptomyces hygroscopicus ATCC 39305 . Fermentation recovery, purification and crystallization were achieved using standard procedures . CP-60,993 was characterized as a monocarboxylic acid . Elemental analysis suggested a molecular formula of C47H78O14 for the free acid and C47H77O14 Na for the sodium salt . Crystalline from CP-60,993 sodium salt shows the following properties: m.p . 193-205 degrees C, E1%(1 cm) = 157 at 232 nm, {alpha}25 degrees C(D) + 11.0 (c 1, methanol) . The structure, determined by MS, PMR and CMR, differs from dianemycin only in the stereochemistry at position 19 . This was confirmed by X-ray crystallography carried out on the rubidium salt of CP-60,993 . It exhibited activity in vitro against Gram-positive and anaerobic bacteria, efficacy against Eimeria coccidia in vivo in poultry, and stimulation in vitro of rumen propionic acid production. J Biol Chem, 1990 Jul 15, 265(20), 11508 - 16 Characterization of a tungsten-iron-sulfur protein exhibiting novel spectroscopic and redox properties from the hyperthermophilic archaebacterium Pyrococcus furiosus; Mukund S et al.; The archaebacterium, Pyrococcus furiosus, is a strict anaerobe that grows optimally at 100 degrees C by a fermentative-type metabolism in which H2 and CO2 are the only detectable products . Tungsten is known to stimulate the growth of this organism . A red-colored tungsten-containing protein (abbreviated RTP) that is redox-active and extremely thermostable has been purified . RTP is a monomer of Mr = 85,000 and contains approximately 6 iron, 1 tungsten, and 4 acid-labile sulfide atoms/molecule . Titrations using visible spectroscopy were consistent with the oxidation and reduction of the protein each requiring two electrons/molecule, suggesting that these metals and the sulfide are arranged in two redox active centers . P . furiosus ferredoxin served as an electron acceptor for the protein . Dithionite-reduced RTP exhibited a remarkable and complex EPR spectrum at 6 K with g values ranging from 1.3 to 10.0 . This was shown to arise from the spin-coupling interaction of two paramagnetic centers . One (center A) has a S = 3/2 spin system (effective g values: gx = 3.33, gy = 4.75, and gz = 1.92, where D = 4.3 cm-1 and lambda = 0.135), whereas the EPR properties of the other (center B) could not be deduced . Nevertheless, theoretical analyses show how the redox properties of both centers may be determined using EPR spectroscopy . Their midpoint potentials (Em) at 20 degrees C and pH 8.0 are -410 mV (center A) and -500 mV (center B) with an effective potential for the spin coupled system (Em, A + B) of -505 mV . The Em values are dependent on temperature (delta Em/delta T = -2 mV/degrees C between 20 and 70 degrees C) and pH with pK alpha values of 8.0 (A) and approximately 8.5 (B) . The Em values at 100 degrees C, the growth temperature, were estimated at -590, -650, and -660 mV for centers A, B, and A + B, respectively . These data indicate that RTP catalyzes a dehydrogenase-type reaction of extremely low potential, which involves the transfer of two protons and of two electrons, to and from two adjacent and interacting but nonidentical metal centers. J Pediatr Gastroenterol Nutr, 1990 Jul, 11(1), 109 - 14 Hyperosmolal formula in neonatal piglets: effects on gastrointestinal hormone concentrations, enteric bacterial titers, and small intestinal histology; Szabo JS et al.; Ingestion of hyperosmolal formula (HOF) by neonatal piglets has been shown to cause significant time-dependent reduction in phase 3 myoelectric activity, which persists in the terminal ileum . To determine whether a single hyperosmolal meal leads to elevated concentrations of gastrointestinal (GI) hormones that inhibit intestinal motility and/or promote bacterial proliferation and disruption of intestinal mucosa, we studied 20 healthy neonatal piglets following feeding with an increased HOF (872 +/- 32 mOsmol/kg, n = 10) and commercial pig milk formula (481 +/- 41 mOsmol/kg, n = 10) . Gastrin, secretin, cholecystokinin, and motilin concentrations were determined by radioimmunoassay during fasting and postprandial periods (15, 30, 45, 120, 180, and 240 min) . Gastrin concentrations were significantly increased at 15 and 30 min following a hyperosmolal meal (p less than 0.01), but there were no statistical differences in GI hormone concentrations between groups . These transient elevations of gastrin concentrations are associated with significant postprandial reductions in phase 3 small intestinal myoelectric activity (SIMEA) that we have observed . Aerobic bacterial titers were not significantly different between proximal and distal small intestinal segments or between experimental groups, and anaerobic bacteria were seldom recovered . Thus, SIMEA was not sufficiently altered to produce significant bacterial proliferation . Small intestinal histology, assessed by light microscopy, showed normal proximal and distal small intestinal mucosa in 8 of 10 piglets from each group . Therefore, orogastric instillation of a single hyperosmolal feed does not result in intestinal mucosal damage . Further studies are warranted to determine the effects of hyperosmolal feeds when additional risk factors exist in the neonate. Jpn J Antibiot, 1990 Jul, 43(7), 1225 - 9 {Influences of postoperative prophylaxis treatments on vaginal bacteria flora at hysterectomy}; Chimura T et al.; We performed abdominal hysterectomy and administered aztreonam (AZT) for prophylaxis of postoperative infections, and investigated influences of the antibiotics on vaginal bacterial flora . The obtained results are summarized as follows . 1 . Patients administered with AZT were studied (n = 48) for bacteria isolated from their vaginae preoperatively and at the 7th and the 14th days postoperatively . Groups of patients administered with cephalothin (CET), cefamandole (CMD) and latamoxef (LMOX) were also studied for comparison . 2 . In the AZT group, the rate of isolation of aerobic Gram-positive bacteria was high (68.8-81.4%) whereas those of aerobic Gram-negative and anaerobic bacteria were low . 3 . When changes in isolation frequencies of bacteria from the subjects preoperatively to postoperatively were compared, the following tendencies were observed: increase in the rate of aerobic Gram-positive bacteria was larger in the LMOX group than in the AZT group whereas decrease in the rate of aerobic Gram-negative bacteria was largest in the LMOX group followed by the AZT group then by the CMD group . Rates of decrease of anaerobic bacteria showed similar tendencies to the latter . Isolation rates of Candida sp . showed the largest increase in the LMOX group, followed by CET, CMD then AZT groups. Cesk Epidemiol Mikrobiol Imunol, 1990 Jul, 39(4), 193 - 200 {Noxythiolin VUFB as part of antimicrobial prophylaxis and therapy in inflammatory intraabdominal complications in surgery}; Vyhnanek F et al.; The author investigated the antimicrobial action of noxythioline, prepared by the Research Institute for Pharmacy and Biochemistry in Prague, in laboratory work as well as under clinical conditions . In the laboratory investigation the author assessed the minimal inhibitory concentration against aerobic and anaerobic bacteria within the range of 512-2048 mg/l, which is sufficient from the aspect of the noxythioline concentration (2.5%) used in clinical work . In the clinical part of the investigation noxythioline was administered to 58 patients hospitalized at the surgical clinic of the Medical Faculty of Hygiene in Prague in 1988-1989 . In 13 patients it was used prophylactically in planned or acute intraabdominal operations . Therapeutically it was used in 45 patients operated mostly on account of intraabdominal diseases complicated by peritonitis or an abscess . Preliminary results confirmed the satisfactory effect of noxythioline VUFB which is comparable with Noxyflex S of Geistlich Co. Antibiot Khimioter, 1990 Jul, 35(7), 23 - 5 {Experimental criteria for interpretation of bacterial sensitivity to dioxidine determined by diffusion from the disks}; Ponomareva TR et al.; Antibacterial activity of dioxidine against aerobic and facultative anaerobic organisms under conditions of anaerobiosis i . e . conditions really observed for example in abscess cavities or necrotic tissues is 30 to 100 times as high as that under aerobic conditions . There is a relationship between sensitivity of bacteria to dioxidine under aerobic and anaerobic conditions which is expressed by the regression equation . Therefore, comparison of the MICs determined under anaerobic conditions with the growth inhibition zones formed by disks with the drug under aerobic conditions is possible . The MIC of dioxidine was determined under anaerobic conditions for 179 clinical strains of aerobic and facultative anaerobic bacteria and the growth inhibition zones of the same bacteria under aerobic conditions were evaluated with the use of disks containing 100, 75, 50, 25, 20, and 15 micrograms of the drug . The border line . MIC differentiating between resistant and sensitive strains was chosen to be equal to 4 micrograms/ml . Differentiation of the strains into sensitive and resistant ones by the values of the growth inhibition zones was performed with the method of error minimization described by C . Metzler and R . De Haan in 1974 . Disks containing 25 micrograms of the drug allowed one to differentiate the strains under aerobic conditions into sensitive and resistant ones: the growth inhibition zones greater than 11 mm corresponded to the sensitive strains (the MIC smaller than 4 micrograms/ml) and the growth inhibition zones smaller than 11 mm corresponded to the resistant strains (the MIC greater than 4 micrograms/ml). Arch Esp Urol, 1990 Jul-Aug, 43(6), 597 - 600 {Perineo-scrotal gangrene (Fournier's gangrene)}; Ruiz Rubio JL et al.; Four cases of perineoscrotal gangrene are reported herein . All were immune-suppressed and three were diabetics . Its primary focus was in the GU tract or intestine . Culture was positive for Gram-negative aerobes and anaerobes . Early aggressive surgery and adjuvant antibiotic therapy achieved an excellent survival rate. Diagn Microbiol Infect Dis, 1990 Jul-Aug, 13(4), 353 - 5 Broth-disk elution tests to predict the susceptibility of anaerobic bacteria to the ampicillin-sulbactam combination; Jones RN; The ampicillin-sulbactam Wilkins-Chalgren agar dilution MICs (2 ratios) were compared with the results of broth-disk elution (BDE) tests using various numbers of disks corresponding to elution breakpoints of less than or equal to 8:8 micrograms/ml, less than or equal to 16:8 micrograms/ml, and less than or equal to 16:16 micrograms/ml . This study showed that a 2:1 ratio MIC test and a 16:8 micrograms/ml BDE breakpoint were best for anaerobic organisms; a recommendation consistent with susceptibility testing criteria for rapidly growing aerobic species . The addition of four ampicillin disks (10 micrograms) and four ampicillin-sulbactam discs (10:10 micrograms) to 5 ml of thioglycolate broth was recommended . This test would achieve greater than 99% comparative accuracy to MICs determined with the reference National Committee for Clinical Laboratory Standards agar dilution method. Ugeskr Laeger, 1990 Jun 18, 152(25), 1822 - 3 {Pyometra without accompanying malignant uterine disease}; Rasmussen KL et al.; Twenty-two cases of non-malignant pyometra which were observed during a period of 15 years are described . 22% were recurrences . All of the women were postmenopausal with discharge and haemorrhage as the commonest symptoms . Pyrexia was rare . Pyometra cannot be excluded or diagnosed by means of gynaecological examination . In cases of suspected pyometra, thorough cervical dilatation and curettage are recommended . Antibiotics should only be administered if there is evidence of invasive infection, in the form of pyrexia, generalised malaise or altered laboratory parameters . In cases such as these, preparations which are effective for aerobic and also anaerobic bacteria should be employed . Follow-up control every six months is recommended on account of the great tendency to recur. J Am Vet Med Assoc, 1990 Jun 15, 196(12), 1965 - 6 Identification of anatomic features of the equine clitoris as potential growth sites for Taylorella equigenitalis; McAllister RA et al.; A median clitoral sinus, as a space canalized from epithelial cells, was distinguishable developmentally in equine fetuses from 33-mm crown-rump length (CRL) to 500-mm CRL (including a mule of 21-mm CRL) . In saggital sections of the clitoris of a 480-mm CRL fetus, indentations under the transverse frenular fold were identified as lateral sinuses of the clitoris . Unlike the median sinus, they were shallow; it therefore could not be anatomically substantiated that the lateral sinuses were of sufficient depth to support the growth of the partial anaerobe Taylorella equigenitalis, the organism of contagious equine metritis . This study indicated excision of the lateral clitoral sinuses was unnecessary for treatment of contagious equine metritis. J Biol Chem, 1990 Jun 15, 265(17), 9842 - 9 Purification and characterization of a microbial, NADP-dependent bile acid 7 alpha-hydroxysteroid dehydrogenase; Franklund CV et al.; A constitutively expressed 7 alpha-hydroxysteroid dehydrogenase (7 alpha-HSDH) has been purified over 1200-fold, to apparent homogeneity, from an intestinal anaerobic bacterium . The purified protein had a subunit molecular mass of 32 kDa as judged by sodium dodecyl sulfate-polyacrylamide gel electrophoresis . Sepharose CL-6B gel filtration gave a native molecular mass estimate of 124 kDa, suggesting that this enzyme existed as a tetramer of identical subunits . Sulfhydryl reactive compounds were potent inhibitors of 7 alpha-HSDH activity, however, metal ion chelators had no effect upon catalytic activity . The purified enzyme was highly NADP-dependent . Bile acid substrate utilization studies revealed that the enzyme was specific for the oxidation of an unhindered 7 alpha-hydroxyl group . A wide variety of bile acids and analogs were used as substrates including glycine and taurine conjugates, and methyl esters, amines, and bile alcohols . The purified 7 alpha-HSDH obeyed Michaelis-Menten kinetics . Hanes plots of substrate saturation kinetics revealed that most bile acid substrates had Km values ranging from 4 to 20 microM, while Vmax was 601 and 674 mumol/min/mg in the direction of bile acid oxidation and reduction, respectively . Primary kinetic plots and product inhibition patterns were consistent with an ordered sequential mechanism, with NADP(H) binding first . The N-terminal amino acid sequence analysis of the purified enzyme revealed a striking homology to several short, non-zinc alcohol/polyol dehydrogenases and a putative, cholate-inducible, hydroxysteroid dehydrogenase from the same organism . The high specific activity together with the stability, substrate range, and ease of purification, make this enzyme an excellent candidate for use in quantitating primary bile acids both in laboratory and clinical samples . Spectrofluorometry allowed for the quantitation of as little as 10 nM of both free and conjugated primary bile acids. Antimicrob Agents Chemother, 1990 Jun, 34(6), 1262 - 7 In vitro activities of irloxacin and E-3846, two new quinolones; Garcia-Rodriguez JA et al.; Irloxacin and E-3846 are two new fluorinated quinolones . We evaluated the activities of these antimicrobial agents, ciprofloxacin, ofloxacin, enoxacin, pefloxacin, norfloxacin, and nalidixic acid against 1,161 bacterial strains . Ciprofloxacin was the most active quinolone . Irloxacin did not show great activity . The activity of E-3846 against gram-negative bacteria was similar to those of ofloxacin and pefloxacin, and E-3846 was the most active quinolone against gram-positive bacteria and anaerobes. J Clin Microbiol, 1990 Jun, 28(6), 1380 - 4 Description of a medium for isolating Anaerobiospirillum spp., a possible cause of zoonotic disease, from diarrheal feces and blood of humans and use of the medium in a survey of human, canine, and feline feces; Malnick H et al.; Anaerobiospirillum spp., motile, spiral anaerobic bacteria, have been implicated as a cause of diarrhea and bacteremia in humans . Anaerobiospirillumlike organisms and Anaerobiospirillum succiniciproducens were reported from 17 cases of diarrhea . Sixteen of the patients did not have any underlying disorders and recovered from the infection; the other one, who had a heart defect, did not . The formulation of a selective medium for Anaerobiospirillum spp . has enabled a survey of human, cat, and dog feces as possible sources for these anaerobic bacteria . Anaerobiospirillum spp . were not isolated from 527 "normal" human feces but were found in both cat and dog feces . We also describe biochemical tests and API ZYM results of A . succiniciproducens and anaerobiospirillumlike organisms. Surg Gynecol Obstet, 1990 Jun, 170(6), 527 - 32 Appendicitis in children; Putnam TC et al.; A study of 406 consecutive children operated upon for appendicitis from July 1982 to July 1987 was compared with a previously published study of 657 children with the same diagnosis operated upon between 1972 and 1982 . This was done to determine if the methods of therapy continue to yield low complication rates and zero mortality rates . The routine use of antibiotic coverage for both aerobic and anaerobic bacteria in perforated appendicitis resulted in low complication rates, 3.2 per cent for major and 2.5 per cent for minor complications . Major complications included small intestinal obstruction and intra-abdominal abscess . Minor complications included wound infection and prolonged ileus . These rates are similar to those of the first investigation . The mortality rate continued to be zero . Complete peritoneal lavage was used in patients with generalized peritonitis or extensive localized peritonitis . Operative lysis of adhesions for small intestinal obstruction was required in four of these patients . This did not occur in patients with perforated appendicitis with abscess formation or more localized peritonitis who had no lavage . The technique rather than the disease process may be responsible for the complication. J Indian Med Assoc, 1990 Jun, 88(6), 154 - 6 Anaerobic bacterial flora of wound sepsis; Arora S et al.; Two hundred specimens from wound infection (surgical and non-surgical) were cultured for the isolation of anaerobic and aerobic bacteria . Positive cultures were obtained in 174 (87%) and 26(13%) were sterile . Anaerobes were isolated from 31(17.8%), as single culture in 6(3.4%) and as mixed culture with aerobes in 25(14.3%) . Amongst anaerobes, anaerobic cocci were predominant (45.9%) . Of aerobes Staph pyogenes (35%) was predominant . Metronidazole was the most effective drug against anaerobes and gentamicin against aerobes . No significant difference was noted in antimicrobial susceptibility of anaerobes of surgical and non-surgical wounds . Among aerobes high resistance was observed in surgical wounds. Probl Vet Med, 1990 Jun, 2(2), 348 - 61 Bacteremia and septicemia in small animal patients; Nostrandt AC; Bacteremias and septicemias are diagnostic and therapeutic challenges . Disseminated bacterial infections may be associated with a number of different conditions and can present with any of a wide variety of clinical signs . Additionally, they are often complicated by the adverse effects of an overzealous immune response in the patient . The most immediately severe and life threatening of these complications is septic shock, a frequent sequela to bacteremia characterized by endotoxin-producing gram-negative microorganisms . Infection with any of a large number of gram-positive or gram-negative aerobes or anaerobes is possible, as is mixed infection . Definitive diagnosis of bacteremia is by repeatable isolation of the pathogen(s) from culture of the patient's blood . Successful therapeutic outcome is dependent on early diagnosis and prompt treatment with a prolonged course of high doses of bactericidal antibiotics, facilitated by in vitro sensitivity testing. Hinyokika Kiyo, 1990 May, 36(5), 627 - 9 {Fournier's gangrene: a case report}; Moriguchi H et al.; A 40-year-old male was admitted complaining of high grade fever, pain, redness and swelling of the right scrotum, right perineum and right flank region . He had no apparent history of previous infection or diabetes mellitus . At the time of admission, the scrotum was partly necrotic with repulsive feculent pus discharge and there was crepitus on palpation of involved areas . Culture of purulent discharge yielded the growth of anaerobic organisms . Surgical drainage was performed immediately and debridement of necrotic tissue in the involved areas was often repeated . At the same time, the patient received antibiotic therapy that included agents effective against anaerobic bacteria . However, the scrotal skin developed gangrene and the right testis hung suspended with cord exposed . This testis was intact . The scrotal skin defect was cured using a skin graft, after the infection had been brought under control. Antibiot Khimioter, 1990 May, 35(5), 40 - 1 {Antibacterial chemotherapy in anaerobic osteomyelitis caused by gunshot wounds}; Shcherbin FG et al.; Thirty three patients with a 7-year history of chronic gunshot osteomyelitis were examined . Non-sporogenic anaerobes were isolated from 28 patients . Gram-positive cocci and gram-negative rods predominated in the anaerobic microflora . Radical surgical interventions combined with adequate antibacterial chemotherapy yielded satisfactory results . The postoperative cavities were drained to provide aerobic conditions in all the parts . Antibacterial drugs and in particular dioxidine solutions and KF were used locally . When antibioticograms were available 7 to 10 days after, the antibiotics in combination with enzymes such as terrylitin and lidase were used with constant irrigation of wounds with furacillin or boric acid solutions . In the empirical therapy, the following scheme was most frequently used: 600 mg of lincomycin, thrice, intramuscularly; 80 mg of gentamicin, thrice, intramuscularly and as an obligatory agent 500 mg of trichopol, thrice, orally . After availability of the antibioticograms the use of the antibiotics was adjusted and continued up to 10 to 12 days . In severe cases 0.1% solution of dioxidine was used intravenously drop-wise in a dose of 300 mg 2 times a day as well as tiberal or clindamycin, intravenously, drop-wise . The antibacterial drugs were added to the drainage until the latter was removed . Relapses of the disease over 4 years were observed only in 3 out of 26 operated patients. Minerva Stomatol, 1990 May, 39(5), 357 - 60 {Inhibition of the immune response due to the volatile fatty acids produced by anaerobic bacteria in the periodontal pocket}; Eftimiadi C et al.; Short-chain fatty acids produced by anaerobic bacteria of the periodontal pockets inhibit lymphocytes activation . The highest degrees of immunosuppressive activity is produced by butyric acid. Zhonghua Wai Ke Za Zhi, 1990 May, 28(5), 278 - 80, 317-8 {Comprehensive study of percutaneous transhepatic aspiration bile culture and cholangiography}; Wang ML; In this study, the results of transhepatically aspirated bile culture, and cholangiography done in 220 cases with biliary tract diseases were presented . Aerobes and anaerobes were found in 76.4% and 64.7% of all samples respectively . Patients with partial common bile duct obstruction from stricture and choledocholithiasis had markedly higher positive cultures than that with simple gallbladder stones and complete common duct obstruction secondary to carcinomas of the pancreas or ampulla . Bile culture from patients with symptomatic cholangitis was much more often positive than those with asymptomatic cholangitis . It was also found that patients with positive bile cultures were more prone to after-PTC acute cholangitis . This study suggested that bile organisms are mainly from the gut, bile organisms and bile duct obstruction are two major causes of acute cholangitis, abrupt elevation of bile pressure during PTC procedure was also a causing factor of acute cholangitis . The authors advocate the comprehensive and prophylactic use of antibiotics both effective to aerobes and anaerobes in the treatment of biliary tract infection. Presse Med, 1990 Apr 4, 19(13), 625 - 8 {An imipenem-cilastatin combination in the treatment of infection in hemato-oncology}; Espinouse D; The efficacy and tolerability of imipenem-cilastatin were studied in 66 haemato-oncology patients from 16 centres presenting with a bacteriologically proven infection; 29 of the patients had neutropenia (less than 500/sq.mm) . The drug was given as monotherapy in 30 cases, as bitherapy in 29 cases and as tritherapy in 7 cases . The initial clinical diagnosis was septicaemia in 29 patients, various severe infections in 31 and fever of unknown origin in 6 . The infection was bacteriologically documented in 55 patients; the remaining 11 patients were kept in the study and the results of their treatment were taken into account . One-hundred and fourteen bacterial strains were isolated, including 64 Gram-negative organisms, 48 Gram-negative organisms and 2 anaerobes . Treatment was discontinued in 4 patients, due to lack of response in 2 and to adverse events (haemolytic shock, Lyell's syndrome) in 2 . Five patients died during the study: 4 of an underlying pathology, the infection having subsided, and 1 of persistent infection and the above-mentioned Lyell's syndrome . Clinical success was achieved in 63 patients (95.5 per cent), including 27 of the 29 patients with neutropenia (93.1 per cent) . Among the 114 strains isolated, 106 were eradicated, 5 persisted and only 1 became resistant (outcome not available in 10 cases) . Apart from the haemolytic shock and Lyell's syndrome, haematological and hepatic alterations were minor and not obviously due to imipenem-cilastatin . Three cases of colonization and 3 cases of superinfection were recorded during the study. Presse Med, 1990 Apr 4, 19(13), 616 - 9 {Value of an imipenem-cilastatin combination in surgery and surgical care units}; Bouletreau P; One-hundred and ninety-nine patients with severe infection caused by susceptible organisms were treated with imipenem-cilastatin administered intravenously in doses of 31 mg/kg/day on average . The drug was given alone in 71 per cent of the cases and with another antibiotic (usually an aminoglycoside) in 13 per cent . In 57.4 per cent of the patients several micro-organisms were involved . Clinical success was achieved in 169 patients (84.9 per cent), 129 of whom (64.8 per cent) were cured and 40 (20.1 per cent) were improved . Failure was observed in 30 patients (15.0 per cent) . Fifteen patients died during treatment; death was directly related to the infection in 5 and occurred while the infection had clinically regressed in 5; in the remaining 5 patients persistence of the infection played a determinant role in the fatal outcome . In 15 patients the lack of clinical improvement under imipenem-cilastatin required by 5/65 Pseudomonas strains and 2/56 Anaerobes strains initially isolated, or to superinfection, or to persistence of the initial strain in the focus of infection . Treatment was discontinued in 8 cases due to adverse events (skin intolerance 4, thrombocytopenia 4) . There was no statistically significant difference in the outcome of patients treated with imipenem-cilastatin alone or combined with another antibiotic. Eur J Obstet Gynecol Reprod Biol, 1990 Apr, 35(1), 69 - 73 Gardnerella vaginalis in posthysterectomy infection; Kristiansen FV et al.; Eighty-six women were admitted for abdominal hysterectomy . Preoperatively, 43 women were culture-positive for Gardnerella vaginalis from the cervical os, and 43 women were culture-negative . Postoperatively, 18 patients developed inflammation; among those 14 patients from the culture-positive group were infected, whereas only 4 patients from the culture-negative group developed inflammation . The difference between occurrence of G . vaginalis and the absence of the bacteria in patients with postoperative infection is highly significant . No such increased risk of postoperative infection was correlated to the isolation of any other microorganism looked for viz . aerobic and anaerobic bacteria, yeasts, viruses or chlamydiae . G . vaginalis may play a causative role in the development of posthysterectomy infection. J Clin Microbiol, 1990 Apr, 28(4), 795 - 7 Effect of altered headspace atmosphere on yield and speed of detection of the Oxoid Signal blood culture system versus the BACTEC radiometric system; Weinstein MP et al.; The one-bottle Oxoid Signal blood culture system altered to provide a more aerobic bottle headspace was reassessed in a comparative study versus the two-bottle BACTEC radiometric system in 5,426 blood cultures . The BACTEC system detected more microorganisms (P less than 0.02), particularly anaerobes (P less than 0.05) and fungi (P less than 0.05). J Bacteriol, 1990 Apr, 172(4), 2065 - 70 Catabolic thiosulfate disproportionation and carbon dioxide reduction in strain DCB-1, a reductively dechlorinating anaerobe; Mohn WW et al.; Strain DCB-1 is a strict anaerobe capable of reductive dehalogenation . We elucidated metabolic processes in DCB-1 which may be related to dehalogenation and which further characterize the organism physiologically . Sulfoxy anions and CO2 were used by DCB-1 as catabolic electron acceptors . With suitable electron donors, sulfate and thiosulfate were reduced to sulfide . Sulfate and thiosulfate supported growth with formate or hydrogen as the electron donor and thus are probably respiratory electron acceptors . Other electron donors supporting growth with sulfate were CO, lactate, pyruvate, butyrate, and 3-methoxybenzoate . Thiosulfate also supported growth without an additional electron donor, being disproportionated to sulfide and sulfate . In the absence of other electron acceptors, CO2 reduction to acetate plus cell material was coupled to pyruvate oxidation to acetate plus CO2 . Pyruvate could not be fermented without an electron acceptor . Carbon monoxide dehydrogenase activity was found in whole cells, indicating that CO2 reduction probably occurred via the acetyl coenzyme A pathway . Autotrophic growth occurred on H2 plus thiosulfate or sulfate . Diazotrophic growth occurred, and whole cells had nitrogenase activity . On the basis of these physiological characteristics, DCB-1 is a thiosulfate-disproportionating bacterium unlike those previously described. Oral Microbiol Immunol, 1990 Apr, 5(2), 90 - 4 Improved detection of oral spirochetes with an anaerobic culture method; Umeda M et al.; A method for routine culturing of oral spirochetes was studied in periodontitis patients and subjects with healthy gingivae . Subgingival plaque bacteria, including oral spirochetes were cultured anaerobically using the steel wool jar method, the glove-box procedure and the plate-in-bottle method . They were also observed directly with a phase-contrast microscope . The number of colonies of recovered spirochetes was significantly higher with the plate-in-bottle method when Medium 10 (M10) or M10 supplemented with 10% rumen fluid was used . In almost all cases, spirochetes were detected with this culture method . The ratios of spirochetes from patient samples, cultured by the plate-in-bottle method, and of other microorganisms, cultured in Eggerth-Gagnon (EG) medium by the steel wool jar method, were almost identical of those observed by phase-contrast microscopy . These results indicate that it can be just as possible to culture certain oral spirochetes as other anaerobic bacteria. Am J Med, 1990 Mar 23, 88(3C), 34S - 37S; discussion 38S-42S Gram-negative bacillary pneumonia in the nosocomial setting . Role of aztreonam therapy; Cook JL; Gram-negative bacterial pneumonia is the leading cause of fatal nosocomial infection in this country . Predisposing factors include altered upper respiratory tract flora and altered barriers that normally protect the sterile lower respiratory tract from invasion by pharyngeal bacteria . Aztreonam, which is highly active against most gram-negative pathogens and which does not cause nephrotoxicity, has been evaluated in the treatment of nosocomial pneumonia . In vitro and pharmacokinetic data on aztreonam indicate that this agent provides an alternative agent for use when resistance to cephalosporin and aminoglycoside antibiotics has developed . Data further suggest that aztreonam may interact synergistically with aminoglycosides against gram-negative pathogens . Clinical study supports the usefulness of aztreonam against gram-negative nosocomial pneumonia . Since aztreonam is inactive against gram-positive and anaerobic bacteria, it must be used in combination with other antibiotics when these pathogens are suspected. Biochem Biophys Res Commun, 1990 Mar 16, 167(2), 568 - 74 Quinone mediated ATP production in the filarial parasite Setaria digitata; Santhamma KR et al.; The cattle filarial parasite Setaria digitata, a facultative anaerobe which is reported to be cyanide insensitive, lacks cytochromes and presents many unique characters . Experiments showed the occurrence of two lower quinones Q6 and Q8 and its rapid synthesis is revealed by a {14C} acetate incorporation study . A schematic quinone mediated hydrogen peroxide production with the generation of ATP through oxidation of substrates has been proposed . Search for specific blockers at the level of quinone might prove to be an effective measure for the control of filarial parasites and thereby filariasis. Hua Xi Yi Ke Da Xue Xue Bao, 1990 Mar, 21(1), 107 - 10 {Application of ion chromatography to identification of anaerobic bacteria}; Fan X et al.; The fatty acids of anaerobic bacteria were detected by ion chromatography (IC) . The results showed that 11 kinds of standard fatty acids could be analyzed within 15 min, and just needed 1 injection sample . The fatty acids patterns of 40 strains of anaerobic bacteria detected by IC were essentially the same as that by gas chromatography (GC) reported by VPI . In comparison with GC, IC has further advantages: pretreatment is simpler, both volatile and non-volatile fatty acids can be analyzed at the same time, and formic and lactic acid can be well analyzed. Rozhl Chir, 1990 Mar, 69(3), 135 - 8 {A case of anaerobic emphysematous cholecystitis with a subhepatic abscess}; Dvorak J et al.; The authors describe their own observation of a complicated course of emphysematous cholecystitis caused by anaerobic microorganisms . An extensive subhepatic abscess was involved which developed as a results of emphysematous cholecystitis diagnosed by sonographic and CT examination . After two operations on account of the abscess and a phlegmon of the abdominal wall the patient recovered . The authors emphasize that early diagnosis and adequate treatment calls for collaboration of clinicians, microbiologists and roentgenologists. J Clin Pathol, 1990 Mar, 43(3), 253 - 6 Comparison of solid media for cultivation of anaerobes; Heginbothom M et al.; Two commercial agar media for the cultivation of anaerobes were compared with four other media for their ability to support the growth of a wide range of anaerobes from clinical specimens of subgingival plaque . Fastidious anaerobe agar (FAA, Lab M) and anaerobe agar (GAA, Gibco) allowed better growth of the pure cultures than the other media . FAA recovered the highest numbers of bacteria from subgingival plaque specimens which were composed predominantly of anaerobes . GAA performed poorly with these samples . It is concluded that FAA seemed to be superior to the other media tested for the cultivation and recovery of anaerobes. J Vet Pharmacol Ther, 1990 Mar, 13(1), 76 - 80 Pharmacokinetics of tinidazole in the horse; Pyorala S et al.; Serum tinidazole concentrations were monitored in five clinically healthy adult horses after intravenous (i.v.) and oral administration of the drug (15 mg/kg and 25 mg/kg, respectively) . After i.v . administration, the mean residence time was 7.0 h, the elimination half-life 5.2 h and the body clearance rate 1.6 ml/min/kg . The distribution volume was found to be 660 ml/kg . After oral administration, the mean residence time was 8.5 h, the absorption half-life 1.1 h and the bioavailability essentially 100% . In view of the in-vitro sensitivities of various anaerobic bacteria, a dosage of 10-15 mg/kg of tinidazole, orally, at 12-h intervals, can be recommended for the treatment of anaerobic infections in horses. J Reprod Med, 1990 Mar, 35(3 Suppl), 333 - 8 Ticarcillin/clavulanate for the treatment of female genital tract infections . Efficacy, safety and comparative microbiology; McGregor JA; In an open study, ticarcillin/clavulanate was used to treat upper genital tract infections in 91 women . The clinical success rate was 92% in outpatient-acquired salpingitis (pelvic inflammatory disease), 50% in salpingitis with tuboovarian abscess, 85% in postpartum endometritis, 87% in endometritis after chorioamnionitis and 90% in postoperative parametritis . The primary adverse reaction was diarrhea, in 10 patients . Among the 129 aerobes isolated, 18 (14%) were beta-lactamase positive, as were 32% (20/63) of the anaerobes. Infect Immun, 1990 Mar, 58(3), 619 - 24 Mortality and bacteriology of sepsis following cecal ligation and puncture in aged mice; Hyde SR et al.; Epidemiologic data suggest that elderly adults are more susceptible to invasive bacterial infection by indigenous gut flora than are younger adults . The purpose of this investigation was to characterize a murine model of clinically encountered peritonitis in the aged . We subjected three different age groups (young, 16 weeks; mature, 12 months; senescent, 24 months) of C57BL/6NNia mice to surgically induced peritonitis by the cecal ligation and puncture procedure . Senescent mice died in a significantly shorter time following surgery than mature mice (median time to death, 24.4 versus 38.5 h, respectively; P less than or equal to 0.001) . Blood, liver, spleen and occasionally, ceca were obtained at 2 and 12 h after the cecal ligation and puncture procedure and immediately following death, to characterize the bacterial kinetics of the model . Qualitative and quantitative aerobic, anaerobic, and coliform cultures were performed . No age-related differences were found in the types of bacteria isolated throughout the time course of progressive sepsis . In mice in the mature and senescent age groups, at 2 and 12 h postsurgery, gram-negative anaerobes and gram-positive aerobes predominated in all tissues that were cultured . At the time of death, however, blood and tissue isolates consisted predominantly of coliform bacteria . The shift from mixed infection during sepsis to predominantly gram-negative bacterial infection reflected a similar progressive shift in bacterial types found in the cecum . At death, senescent mice had 100-fold fewer coliform bacteria in the bloodstream than those found in mature mice (2.5 x 10(9) versus 4.6 x 10(11), respectively) . The increased sensitivity of aged mice to invasive bacterial infection documented in this series of experiments accords well with human epidemiologic experience and demonstrates the appropriateness of the model for continued investigations of sepsis in the aged. J Reprod Med, 1990 Mar, 35(3 Suppl), 353 - 8 Ticarcillin/clavulanate . An alternative to combination antibiotic therapy for treating soft tissue pelvic infections in women; Faro S; Soft tissue pelvic infections--i.e., postpartum endometritis, endometritis, pelvic inflammatory disease and pelvic cellulitis--are predominantly polymicrobial . The microflora of these infections consists of a mixture of gram-positive and -negative bacteria, including aerobes and facultative and obligate anaerobes . Clindamycin plus gentamicin has been the principal antibiotic combination utilized for treatment of these infections . Ticarcillin/clavulanate appears to be an excellent replacement for initiating empiric therapy for these infections because of its safety and broad spectrum of activity, which includes gram-negative and -positive aerobic and anaerobic bacteria. J Reprod Med, 1990 Mar, 35(3 Suppl), 348 - 52 Infectious morbidity in gynecologic oncology; Graham JE Jr; Infectious complications are the most frequent cause of death in cancer patients . Broad-spectrum antibacterial therapy is dictated by the polymicrobial nature of infections encountered in gynecologic oncology and is imperative in the empiric therapy of febrile granulocytopenic patients . In addition, the potential for infectious complications after radical pelvic surgery to remove malignancies has influenced most gynecologic oncologists to recommend prophylactic antibiotics . However, the choice of appropriate antibacterial therapy in gynecologic oncology patients is complicated frequently by impaired renal function secondary to cancer chemotherapy or associated with age in this generally elderly population . In addition, the potential cost- and time-saving advantages of simplified antibacterial regimens have resulted in a reexamination of the standard aminoglycoside-containing multiple-drug regimens . The efficacy and safety of monotherapy with broad-spectrum beta-lactam antibiotics or beta-lactam-antibiotic/beta-lactamase-inhibitor combinations, such as ticarcillin/clavulanate, remain to be confirmed in gynecologic oncology patients . The broad spectrum of ticarcillin/clavulanate, including gram-negative and -positive aerobic and anaerobic bacteria, seems plausible for the treatment of these potentially devastating infections. J Trauma, 1990 Mar, 30(3), 324 - 7 Aeromonas hydrophila water-associated traumatic wound infections: a review; Semel JD et al.; The bacterium Aeromonas hydrophila is commonly found in natural bodies of water, and is a potential invasive pathogen for those who suffer trauma while submerged in water . Five patients treated by the authors and 18 previously reported patients were reviewed to further define the characteristics of A . hydrophila wound infections . Although Aeromonas has been isolated from salt and brackish water, all 23 cases occurred following contact with fresh water . Signs of infection usually appeared 8-48 hours following puncture or laceration injury . The foot or leg were most commonly involved . Infection was frequently rapidly progressive; fascia, tendon, muscle, bone, or joint involvement occurred in 39% of cases . In addition to A . hydrophila, other aerobic and anaerobic bacteria were found in 48% of cases . Aeromonas infection should be suspected in cases of early and rapidly progressive wound infection following trauma in fresh water . Broad-spectrum antimicrobial therapy and appropriate surgical care should be promptly instituted. Int J STD AIDS, 1990 Mar, 1(2), 122 - 5 Microbiological flora in men with non-gonococcal urethritis with particular reference to anaerobic bacteria; Woolley PD et al.; In a microbiological study of the urethral flora in men with non-gonococcal urethritis (NGU), Chlamydia trachomatis (isolated from 30% of men) was the only organism isolated significantly more often from men with NGU than controls (P less than 0.01) . Bacteroids species, especially of the melaninogenicus-oralis group, were the predominant anaerobic bacterial isolate from both men with NGU (isolated from 24%) and controls (isolated from 30%) . There was no evidence that aerobic bacteria, anaerobic bacteria or herpes simplex virus made a significant contribution as primary pathogens in non-chlamydial NGU . Gram-positive cocci were the only anaerobic organism isolated more often from chlamydia-positive men (29%) than chlamydia-negative men (16%) with NGU (P less than 0.01) . The significance of this remains unclear. Biochim Biophys Acta, 1990 Feb 9, 1037(2), 161 - 4 Phosphofructokinase from a vertebrate facultative anaerobe: effects of temperature and anoxia on the kinetic parameters of the purified enzyme from turtle white muscle; Brooks SP et al.; The effects of low temperature and anoxia were determined on phosphofructokinase (PFK) purified from white skeletal muscle of the freshwater turtle, Pseudemys scripta . These effects were assayed by comparing PFK kinetic constants measured at a high (20 degrees C) and low (6 degrees C) temperature using enzyme obtained from animals held under normoxic and anoxic conditions . When assayed at 20 degrees C, PFK from anoxic animals had a lower Ka for phosphate, a lower Ka for AMP and showed no inhibition with increasing concentrations of ATP (up to 10 mM) when compared to enzyme from normoxic animals . At 6 degrees C, anoxic enzyme had a higher Km for fructose 6-phosphate and a higher I50 value for citrate with respect to normoxic enzyme . Decreasing temperature also had a differential effect on PFK kinetic parameters depending on the source of the enzyme . When normoxic enzymes were compared at 20 and 6 degrees C, the enzyme measured at 6 degrees C showed a lower Km for ATP and a lower Ka for AMP . Comparison of anoxic enzymes at these two temperatures showed that anoxic PFK at 6 degrees C had a higher Ka for phosphate, a higher Ka for AMP, and a larger Hill coefficient . A comparison of maximal velocities at varying temperature showed that normoxic enzyme (Q10 = 2.22) was more temperature sensitive than the anoxic enzyme (Q10 = 1.80) . It is possible to interconvert the normoxic and anoxic forms of PFK by incubating normoxic enzyme with the active subunit of protein kinase, suggesting that the kinetic changes observed during anoxia resulted from enzyme phosphorylation . These data are discussed with respect to the mechanisms underlying white muscle function during diving and hibernation in red-eared turtles. J Clin Microbiol, 1990 Feb, 28(2), 246 - 8 Evaluation of two single-plate incubation systems and the anaerobic chamber for the cultivation of anaerobic bacteria; Downes J et al.; Three systems that are available for the incubation of anaerobic organisms were evaluated to assess their ability to support the growth of 25 anaerobic stock strains and to successfully recover anaerobic bacteria from clinical specimens . These were the anaerobic chamber, the Anaerobic Pouch System Catalyst-Free (Difco Laboratories, Detroit, Mich.), and the Bio-Bag Environmental Chamber Type A (Marion Scientific, Div . Marion Laboratories, Inc., Kansas City, Mo.) . Three study centers were involved, the Wadsworth Anaerobe Laboratory (Los Angeles, Calif.), the Good Samaritan Hospital (San Jose, Calif.), and the Massachusetts General Hospital (Boston) . A total of 171 anaerobic organisms were isolated from 49 clinical specimens that were cultured at the three test centers . Of these, 169 (99%) were recovered from media that were incubated in the anaerobic chamber, 163 (95%) were recovered from the Anaerobic Pouch, and 147 (86%) were recovered from the Bio-Bag . A similar trend was seen with the stock strains, in which the anaerobic chamber often supported better growth of the organisms than did either of the bag systems. J Theor Biol, 1990 Jan 23, 142(2), 201 - 21 Hyperoxidant states cause microbial cell differentiation by cell isolation from dioxygen; Hansberg W et al.; A general theory giving an explanation of microbial cell differentiation is presented . Based on experimental results, an unstable hyperoxidant state is postulated to trigger differentiation . Simple rules, involving the reduction of dioxygen and the isolation from dioxygen by diverse mechanisms, are proposed to govern transitions between the growth state and the differentiated states . With this view, common features of microbial differentiation processes, dimorphic growth, cell differentiation in dioxygen evolving phototrophs and in anaerobes are analyzed . The theory could have implications for understanding cell differentiation in higher organisms. Ugeskr Laeger, 1990 Jan 15, 152(3), 157 - 60 {Factors determining the development of wound infection after appendectomy}; Vennits BP et al.; In order to illustrate which factors are of significance for the development of wound infection after appendectomy, an extensive prospective material of 2,097 patients submitted to appendectomy was analysed . Regression analyses demonstrated that age alone, employment of preoperative antibiotics (cefoxitin) and patient delay (time from onset of symptoms till admission) were of significance . The present authors conclude, on the basis of this material, that all patients over 25 years of age should be given preoperative antibiotic prophylaxis which covers aerobic and also anaerobic microorganisms . If a gangrenous or perforated appendix is found, antibiotics should be administered intraoperatively if prophylactic treatment has not been administered . In cases of perforation, antibiotics should be administered postoperatively for 72 hours. Rev Infect Dis, 1990 Jan-Feb, 12 Suppl 2, S223 - 30 Anaerobes: problems and controversies in bacteriology, infections, and susceptibility testing; Finegold SM; Three key questions are discussed in this manuscript: (1) What is the clinical relevance of anaerobic bacteriology? (2) How can the microbiologist, with limited and decreasing resources, perform reliable, detailed studies of anaerobic bacteriology? (3) When and how should susceptibility testing be done with anaerobes? If the clinician knows the usual bacteriology of various types of infection and how this may be modified by pathophysiologic processes in the host or by prior therapy, he/she can use a logical empiric approach to treatment of the patient . As to the microbiologist's dilemma, it is not realistic or rational for a microbiologist in a nonteaching hospital to do detailed bacteriologic studies and routine anaerobic susceptibility testing . The resources available should be committed primarily to the patient who is seriously ill . Such allocation of resources, of course, requires repeated and effective communication between microbiologist and clinician. Rev Infect Dis, 1990 Jan-Feb, 12 Suppl 2, S218 - 22 Antimicrobial susceptibility testing of anaerobic bacteria: review and update on the role of the National Committee for Clinical Laboratory Standards; Thornsberry C; The National Committee for Clinical Laboratory Standards (NCCLS) has published a standard method (M11-A) and alternative methods (M17-P) for susceptibility testing of anaerobic bacteria . (These will be combined in the next edition of M11.) Even though M11-A describes the "standard reference" method, there is not agreement as to which method, if any, is the "best" method . In recent years NCCLS subcommittee members have realized that results obtained by microdilution or disk elution may vary markedly from those obtained with the reference agar dilution method . Furthermore, they have recognized the difficulty of relating in vitro susceptibility results to clinical success or failure . In response to these problems, the NCCLS convened a working group to consider recommendations about susceptibility testing . This group has concluded that for most individual patients a susceptibility test may not be required but that present methods can be useful for comparisons of the activity of various drugs and for surveillance of resistance patterns. Rev Infect Dis, 1990 Jan-Feb, 12 Suppl 2, S127 - 32 New methods for identification of obligate anaerobes; Phillips I; Anaerobes are identified in the clinical laboratory to provide a microbiologic diagnosis for the individual patient as well as information on pathogenicity and epidemiology . The level of identification required in each context should be discussed and agreement should be reached . New methods of identification available, or likely to become available, include nucleic acid and immunologic probes, protein electrophoresis, peptidoglycan analysis, detection of volatile metabolic products, and detection of enzymes . The last of these has been widely adopted for the production of commercially available identification kits . All the methods require critical assessment before they are introduced into routine service. J Perinat Med, 1990, 18(2), 139 - 43 Effect of the feeding practices on the establishment of bacterial interactions in the intestine of the newborn delivered by cesarean section; Bezirtzoglou E et al.; The purpose of this study was to clarify the role of the intestinal anaerobe bacteria colonizing the intestine of the newborn delivered by cesarean section . The intestinal bacterial colonization of 18 newborns delivered by cesarean section was assessed sequentially over the first 14 days of life . Emphasis is placed on C . perfringens and upon interaction to other bacteria . Correlation was made with the infant feeding mode . Microbial studies were realized in anaerobic conditions using Columbia blood agar simple and supplemented with antibiotics . Artificial alimentation seemed to favour C . perfringens installation, in contrast to the maternal one which promote B . bifidum proliferation . Antagonism between these bacteria seems to be established in the newborn intestine, via the alimentation. Arch Microbiol, 1990, 153(3), 267 - 71 Strain DCB-1 conserves energy for growth from reductive dechlorination coupled to formate oxidation; Mohn WW et al.; Strain DCB-1 is a strict anaerobe capable of the reductive dechlorination of chlorobenzoates . The effect of dechlorination on the yield of pure cultures od DCB-1 was tested . Cultures were incubated with formate or H2 as electron donors and CO2 as a putative carbon source . Relative to control cultures with benzoate, cultures which dechlorinated 3-chlorobenzoate and 3,5-dichlorobenzoate had higher yields measured both as protein and cell density . On the media tested the apparent growth yield was 1.7 to 3.4 g cell protein per mole Cl- removed . Dechlorination also stimulated formate oxidation by growing cultures . Resuspended cells required an electron donor for dechlorination activity, with either formate or elemental iron serving this function . Resuspended cells did not require an electron acceptor for formate consumption, but reductive dechlorination of 3CB to benzoate stoichiometrically stimulated oxidation of formate to CO2 . These results indicate that DCB-1 conserves energy for growth by coupling formate, and probably, H2 oxidation to reductive dechlorination. Arch Microbiol, 1990, 153(3), 264 - 6 Reductive dechlorination of 3-chlorobenzoate is coupled to ATP production and growth in an anaerobic bacterium, strain DCB-1; Dolfing J; Thermodynamic data that the reductive dechlorination of 3-chlorobenzoate is exergonic have led to the hypothesis that this reaction yields biologically useful energy . This hypothesis was tested with strain DCB-1, a dehalogenating bacterium . The organism was grown under strictly anaerobic conditions in vitamin-amended mineral medium with formate plus acetate as electron donor and 3-chlorobenzoate as electron acceptor . The cell yield increased stoichiometrically to the amount of 3-chlorobenzoate dechlorinated . No growth was observed in the absence of 3-chlorobenzoate, or when 3-chlorobenzoate was replaced by benzoate . To obtain further evidence on that energy is derived from dechlorination, 3-chlorobenzoate was added to starved cells . This amendment resulted in an increase in the ATP level of the cells at 10 nmol per mg protein versus 3 nmol per mg protein in non-amended controls . These data indicate that the reductive dehalogenation of chlorinated aromatic compounds can be coupled to a novel type of chemotrophy. Rev Infect Dis, 1990 Jan-Feb, 12 Suppl 2, S157 - 60 Capnophilic and anaerobic bacteremia in neutropenic patients: an oral source; Baquero F et al.; The currently accepted empiric antibiotic therapy for bacterial infections in neutropenic patients may not cover the possibility of capnophilic and anaerobic bacteremia . Many of these infections develop in patients with severe mucositis or periodontitis, and the type of organisms recovered also suggests an oral source of infection . We present two cases of bacteremia in neutropenic patients who had been empirically treated with ceftazidime and piperacillin plus amikacin . In the first case a beta-lactamase-producing strain of Capnocytophaga ochracea was isolated; in the second case bacteremia was due to a mixture of Leptotrichia buccalis and Fusobacterium nucleatum . These observations emphasize the necessity for a reevaluation of the possible use of antimicrobial agents active against beta-lactamase-producing capnophilic organisms and anaerobic bacteria during empiric therapy in neutropenic patients with an oral source of infection. J Clin Microbiol, 1990 Jan, 28(1), 27 - 31 Adherence of skin bacteria to human epithelial cells; Romero-Steiner S et al.; Aerobic and anaerobic bacteria isolated from human axillae were tested for their capacity to adhere to buccal epithelial cells, immortalized human epithelial (HEp-2) cells, and undifferentiated and differentiated human epithelial cells . In general, both aerobic and anaerobic diphtheroids adhered better to differentiated human epithelial cells than to HEp-2 and undifferentiated human epithelial cells (P less than 0.05) . Mannose, galactose, fucose, N-acetyl-D-glucosamine, and fibronectin were also assayed for their capacity to inhibit the adherence of diphtheroids to human epithelial cells . A great deal of variability was observed in the capacity of the latter compounds to inhibit the attachment of aerobic diphtheroids to undifferentiated and differentiated epithelial cells . Overall, mannose appeared to be best at inhibiting the adherence of the aerobic diphtheroids to undifferentiated human epithelial cells . Galactose, fucose, N-acetyl-D-glucosamine, and fibronectin showed a greater capacity to inhibit attachment of aerobic diphtheroids to differentiated than to undifferentiated human epithelial cells . The inhibition of adherence to differentiated human epithelial cells varied with the microorganism and the compound tested; however, the highest and most consistent inhibition of adherence (76.1 to 88.6%) was observed with a 5% solution of N-acetyl-D-glucosamine . The in vitro adherence and adherence inhibition assays presented here demonstrate that a number of adhesins and receptors are involved in the adherence of skin bacteria to human epithelial cells and receptors on human epithelial cells are apparently altered during differentiation. Chest, 1990 Jan, 97(1), 69 - 74 Yield of percutaneous needle lung aspiration in lung abscess; Pena Grinan N et al.; STUDY OBJECTIVE: To evaluate the accuracy of PLA with a thin needle in the bacteriologic diagnosis of patients with lung abscess and in demonstrating possible coexistence of an underlying lung carcinoma, and the influence of this technique in the treatment and outcome of these patients . DESIGN: Case series . SETTING: Tertiary university referral center . PATIENTS: Consecutive sample of 50 patients with clinical picture suggestive of pulmonary infection and single or multiple cavitation of at least 1 cm in diameter on chest x-ray films, and lack of clinical suspicion of active pulmonary tuberculosis . One patient was excluded from the study after demonstration of tuberculosis by PLA . INTERVENTIONS: Lung aspirates were obtained under fluoroscopic guidance by introduction of a 22-gauge disposable spinal needle within the abscess cavity and were immediately transported to the bacteriology laboratory and pathology department for processing . All patients were initially treated with clindamycin . Tobramycin was added in all those patients with hospital-acquired infection, lack of foulness of sputum, and those who were initially severely ill . Definite treatment was based on the results of bacteriologic cultures . MEASUREMENTS AND MAIN RESULTS: Cultures of LAs were positive in 82 percent (40/49) of patients . In 20 cases the isolates were monobacterial (13 aerobic bacteria and seven anaerobic) . In the remaining 20 cases, cultures grew more than one kind of bacteria (four exclusively aerobic, five exclusively anaerobic, and 11 mixed), with an average of 3.25 types of bacteria per case . Anaerobes were found as a single bacteria or associated with other aerobic bacteria in only 58 percent (23/40) . The results of LA cultures led to change in the initial antibiotic trial in 23 patients (47 percent) . Of ten cases in which bronchogenic carcinoma was demonstrated, cytologic study of LA was done in nine, and eight had positive cytologic yield . Pneumothorax occurred in seven cases (14 percent) as the sole complication . CONCLUSIONS: (1) Percutaneous lung aspiration had a high diagnostic yield and accuracy in our series, with a relatively low incidence of complications . (2) Anaerobic bacteria were less frequently implicated in our cases than previously reported . This finding led to significant changes in the initial empiric antibiotic treatment. Adv Biochem Eng Biotechnol, 1990, 42, 27 - 62 Microbial aggregates in anaerobic wastewater treatment; Kosaric N et al.; The phenomenon aggregation of anaerobic bacteria gives an opportunity to speed up the digestion rate during methanogenesis . The aggregates are mainly composed of methanogenic bacteria which convert acetate and H2/CO2 into methane . Other bacteria are also included in the aggregates but their concentration is rather small . The aggregates may also be formed during acetogenesis or even hydrolysis but such aggregates are not stable and disrupt quickly when not fed . A two stage process seems to be suitable when high concentrated solid waste must be treated . Special conditions are necessary to promote aggregate formation from methanogenic bacteria but aggregates once formed are stable without feeding even for a few years . The structure, texture and activity of bacterial aggregates depend on several parameters: (1)--temperature and pH, (2)--wastewater composition and (3)--hydrodynamic conditions within the reactor . The common influence of all these parameters is still rather unknown but some recommendations may be given . Temperature and pH should be maintained in the range which is optimal for methanogenic bacteria e.g . a temperature between 32 and 50 degrees C and a value pH between 6.5 and 7.5 . Wastewaters should contain soluble wastes and the specific loading rate should be around one kgCOD(kgVSS)-1 d-1 . The concentration of the elements influences aggregate composition and probably structure and texture . At high calcium concentration a change in the colour of the granules has been observed . Research is necessary to investigate the influence of other elements and organic toxicants on maintenance of the aggregates . Hydrodynamic conditions seem to influence the stability of the granules over long time periods . At low liquid stream rates, aggregates may starve and lysis within the aggregates is possible which results in hollowing of aggregates and their floating . At high liquid stream rates the aggregates may be disrupted and washed out of the reactor as a flocculent sludge . Methanogenic bacterial aggregates have been successfully applied in many full scale installations, especially for sugar beet, potato, pulp and paper mill, and other soluble wastes . The UASB reactors used for these treatments are simple in construction and handling which result in rather low total costs . A further and wider application of UASB reactors and methanogenic aggregates for various industrial wastewaters is expected. Scand J Infect Dis Suppl, 1990, 70, 91 - 101 Antimicrobial prophylaxis in oral surgery; Heimdahl A et al.; Postsurgical infections after oral surgery in healthy patients are almost exclusively wound infections caused by aerobic and anaerobic microorganisms endogenous to the oral cavity . Available data indicate that, in otherwise healthy patients, infectious complications after dentoalveolar surgery are decreased after penicillin prophylaxis . However, prophylaxis is still not recommended as a routine procedure, because wound infections are generally mild and easy to deal with . In maxillofacial surgery evidence exists that short term prophylaxis is preferable to long term; however, no definite proof is available to indicate that prophylaxis is preferable at all . In patients with locally or systemically reduced defence mechanisms, antimicrobial prophylaxis is generally advocated . Best defined regimens for antimicrobial prophylaxis in oral surgery concern patients at the risk of endocarditis, while guidelines still have an empiric base in immunocompromised patient groups. Scand J Infect Dis Suppl, 1990, 70, 36 - 44 Antimicrobial prophylaxis in elective colorectal surgery and appendicitis; Roland M; The purpose of this presentation is to evaluate the role of anaerobic and aerobic microorganisms in postoperative infections after colorectal surgery and appendicitis, and to evaluate when antimicrobial agents should be administered prophylactically in conjunction with these operations . In one multicenter study, prophylactic regimens against anaerobic and aerobic microorganisms were compared for durations of one and three days after colorectal surgery . In another multicenter study, the effect of a regimen against anaerobes used alone or in combination with an agent against aerobes in one preoperative dose were compared . The different types of operations had different potential for postoperative infections . An antimicrobial agent against anaerobic microorganisms given as one preoperative dose may suffice in surgery on the upper part of the colon, but a combination with an agent against aerobic bacteria is recommended in rectal surgery . The effectiveness of agents against anaerobic and aerobic bacteria in preventing postoperative infections after appendectomy in cases of gangrenous or perforated appendicitis without general peritonitis were compared in another study . This concluded that an agent against anaerobes is recommended when the appendix is gangrenous or perforated. West Afr J Med, 1990 Jan-Mar, 9(1), 1 - 5 The pattern of presentation of foot lesions in Nigerian diabetic patients; Akanji AO et al.; Foot lesions constitute an important cause of morbidity and mortality in Nigerian diabetics, yet remain poorly characterised . We, therefore, prospectively studied 50 diabetics with 84 major foot lesions over a three-year period at Ibadan, Nigeria . Sixty eight percent of the patients were illiterate and 80% ignorant regarding the importance of footcare . Duration of diabetes was significantly longer in these patients (p less than 0.05) than in age- and sex-matched diabetics without foot lesions . The prevalence rates of neuropathy (68%), foot ischaemia (54%), hypertension (42%) and nephropathy (20%) in diabetics with foot lesions were higher than in previous reported groups of Nigerian diabetics . The initiating factors were predominantly trivial trauma and "spontaneous" blisters . Sixty percent were anaemic at presentation, while short-term glycaemic control was generally poor . Mixed bacterial organisms were cultured in 70% of the cases, with anaerobes presumed present in 33% . Chronic osteomyelitis (38%) and soft tissue changes (35%) were the commonest foot x-ray findings . Some aspects of prevention of foot lesions were discussed. Vestn Dermatol Venerol, 1990, (7), 23 - 5 {The ultrastructure of anaerobes isolated from the urogenital tract of women}; Dmitriev GA et al.; Electron microscopic (ultrathin sections) examination of culture strains of vaginal Gardnerella and bacteroids isolated in aerobic conditions from urogenital tract of women suffering from Gardnerella infection was carried out . Structural analysis of the bacteria is presented, i.e . their shape, size, morphology, and features of multiplication. Arch Histol Cytol, 1990, 53 Suppl, 209 - 18 Macrophage and tissue changes in the developmental phases of secondary lymphoedema and during conservative therapy with benzopyrone; Piller NB; The normal role that the macrophage plays in tissue homeostasis is presented along with the morphological and functional changes that occur to the macrophage population as the lymphoedema progresses from the latent to the chronic phase and then with the treatment with a representative benzopyrone called coumarin . Underlying the lymphoedema, there is a chronic inflammation . It is this, in association with the accumulating protein and the subsequent alterations it produces in the tissues that attract monocytes and macrophages to the affected area . Despite the fact that macrophages are facultative anaerobes, and that larger numbers than normal accumulate, the tissue conditions result in a depression in their activity levels . Apart from these tissue conditions there is the possible production of deactivating proteins such as transforming growth factor beta 1 and 2 . Evidence for this deactivation comes from enzymatic studies in which levels of typical macrophage enzymes are reduced and from morphological work which has shown a reduction in pseudopods and a tendency to accumulate large amounts of lipid in their vacuoles . As a consequence of this deactivation further protein accumulation occurs thereby osmotically attracting fluid . Also there is a tendency for the tissues to become fibrotic as the balance between collagen lysis and deposition shifts towards the latter since it has been shown that macrophages have an important role in collagen lysis . The administration of coumarin stimulates the macrophages resulting to their return to normal or supranormal activity levels within the lymphoedematous tissues . As well as this there is an increase in macrophage numbers . The reasons for stimulation are uncertain, however, alterations in the fine structure of the proteins and complement which make these more attractive for phagocytosis seem the most likely . The end result is an rapid enhanced breakup of the excess interstitial protein and the removal of the osmotically attracted fluid together with a more gradual removal of the deposits of fibrotic tissue by the non-stimulated macrophage . Clinically this manifests itself as a softening of the tissues, a reduction in circumference of the lymphoedematous extremity, a return to normal tissue remodelling processes and a range of subjective improvements for the patient. Rev Pneumol Clin, 1990, 46(3), 91 - 7 {Thoracic actinomycosis . Report of 8 cases}; Patey O et al.; We report 8 cases of thoracic actinomycosis, a disease which is now uncommon owing to the widespread use of antibiotics and which is caused by anaerobic filamentous bacteria living as saprophytes in natural cavities . Recent pathogenetic data, such as propagation by continuity or blood stream, as well as bacteriological and clinical data (mediastino-pulmonary, pleural, parietal, cardiac and disseminated lesions) are reviewed . Diagnostic problems are due to the difficulties encountered in trying to isolate the saprophytic organism, and pathological examination is often required for the diagnosis . Treatment is basically medical and consists of penicillin G or A administered for prolonged periods . Nitroimidazoles are ineffective against these anaerobic bacteria. Henry Ford Hosp Med J, 1990, 38(1), 28 - 32 Cervicofacial actinomycosis in children; Friduss ME et al.; Actinomycotic infections, once common in humans and cattle, are now rare causes of disease in man . This general group of organisms belongs taxonomically between the true bacteria and the fungi; however, the organisms behave clinically like true anaerobes . The organism, although phagocytized by the host cells, is not killed . Therefore, it is defined as a facultative intracellular parasite of the host . The protean manifestations of actinomycotic infections often mimic infectious processes, such as osteomyelitis or granulomatous disease, as well as neoplasia . It is therefore important for the surgeon to include actinomycosis in the differential diagnosis of cervicofacial masses in children as well as in adults . Being an anaerobe, the organism is difficult to culture and the diagnosis must be considered at the time of biopsy of a cervicofacial mass or when culturing a sinus tract . A case of a 12-year-old girl seen at Children's Hospital of Los Angeles prompted the review of our experience with this disease . In this child, actinomycosis presented as an expansile mass in the mandible . From 1956 to 1986, five children were treated for cervicofacial actinomycosis . Detailed case analysis, pathophysiology, clinical characteristics, and current treatment recommendations are presented. Scand J Infect Dis Suppl, 1990, 68, 19 - 22 The pharmacokinetics of oral quinolones (norfloxacin, ciprofloxacin, ofloxacin); Alestig K; The newer fluoro-quinolones including norfloxacin, ciprofloxacin and ofloxacin are all characterized by a good penetration into tissues and cells . In contrast to beta-lactam antibiotics, these quinolones often achieve tissue concentrations which are several times higher than concurrent serum levels . Therefore, MIC values should not be related to serum concentrations only, when possibilities for the use of quinolones in tissue infections are discussed . Following oral administration, norfloxacin and ciprofloxacin are well absorbed and the bioavailability of ofloxacin is almost 100% . Absorption is delayed but not reduced by food . Ofloxacin is mainly excreted unchanged; norfloxacin and ciprofloxacin are metabolized to some extent, but most metabolites are biologically active . Half-lives of the drugs are 3-6 hours and they may therefore be administrated twice daily . These quinolones are excreted by glomerular filtration and tubular secretion but also via faeces . Dose reduction is needed only in patients with severe reduction of kidney function . It has been suggested that when renal function is reduced an increased transintestinal passage of the quinolones may result . In the intestines the quinolones seem to be bound to faeces; anaerobes are mainly unaffected by these antibiotics. Bull Mem Acad R Med Belg, 1990, 145(3-4), 175 - 82; discussion 182-3 {Antiseptic properties of saliva and metabolism of activated oxygen in neutrophils: comparison of the 2 enzymatic bactericidal systems and of their behavior in an acid environment}; Courtois P et al.; Growth control of anaerobes in the oral cavity, is secured--among other means--by: 1) phagocytosis of opsonized bacteria; 2) synthesis of hypothiocyanite by the salivary peroxidase system . The former may be inhibited by bacterial acid byproducts . As for the salivary hypothiocyanite, it proved itself able of hindering in vitro the growth of bacterial strains known as customary periodontal pathogens . Its possible effectiveness in vivo remains however hypothetical in the case of deep gingival pockets according to the poor diffusion there of salivary components. Crit Rev Biotechnol, 1990, 10(2), 119 - 27 The use of microbial membranes to achieve anaerobiosis; Adler HI; The cytoplasmic membranes of many aerobic and facultative bacteria contain enzymes that catalyze the reduction of dissolved oxygen to water . Preparations of small particles derived from such membranes can be filter sterilized without loss of the oxygen-reducing enzymes . These particle preparations can be used to produce anaerobic conditions in a variety of biological environments . They have been shown to stimulate the growth of many anaerobic bacteria and can also be used to stabilize oxygen-sensitive chemical reagents . The particle preparations are stable for long periods of time . They are functional over a pH range and temperature range frequently encountered in biological systems . Various techniques for using the particles are presented . The advantages and limitations of this new approach to achieving oxygen-free conditions are discussed. Clin Ther, 1990, 12 Suppl B, 43 - 53 Intra-abdominal sepsis: a medical-surgical dilemma; Hackford AW; Much progress has been made in our understanding of the pathophysiology of intra-abdominal infection over the past 100 years . By 1900, investigators had evidence of both an aerobic and an anaerobic component in these infections . By the 1970s, the role of gram-negative aerobic organisms in peritonitis and the role of anaerobes in abscess formation were emerging . Improved culture techniques have demonstrated the true polymicrobial nature of intra-abdominal infection . In our most recent study, an average of 3.9 isolates per patient was cultured . Because of the mixed flora present in these infections, antibiotic regimens must be active against both aerobes and anaerobes . This coverage has usually been accomplished with combinations of antibiotics, although some newer, single-agent regimens may also be effective . Even with our increased knowledge, intra-abdominal infection followed by sepsis remains the most common cause of death among patients in the intensive care unit . Mortality is associated with multiple, recurrent, or persisting abscess; positive blood cultures; and organ failure . Surgery, if indicated, should be undertaken before the onset of significant organ failure . Reducing the mortality from organ failure will depend more on the ability to modulate the metabolic and immune pathways that lead to sepsis than on the development of broader-spectrum antibiotics and more aggressive surgical algorithms. NCI Monogr, 1990, (9), 111 - 6 Monotherapy for empirical management of febrile neutropenic patients; Rubin M et al.; New fever in a neutropenic patient mandates prompt institution of empirical broad-spectrum antibiotics . Traditional empirical regimens have relied on combinations that include an aminoglycoside . However, certain classes of newer antibiotics (e.g., third-generation cephalosporins, carbapenems, quinolones) include agents with a broad spectrum and high bactericidal activity that may provide therapeutic alternatives to combination regimens . We previously compared empirical monotherapy with ceftazidime to a combination regimen of cephalothin, gentamicin, and carbenicillin and found the regimens comparable with respect to percentage with success (survival without change of initial regimen; 62% vs 67%), success with modification (survival with additional antibiotics; 33% vs 29%) and failure (death; 5% vs 4%) . Imipenem has a broader in vitro spectrum of activity than ceftazidime, particularly against gram-positive organisms and anaerobes, raising the possibility of equivalent or even improved efficacy as monotherapy . Accordingly, we are prospectively randomizing febrile, neutropenic patients to either empirical ceftazidime or imipenem therapy . Imipenem appears to be comparable to ceftazidime in this ongoing study but has not resulted in fewer modifications or secondary infections . Studies assessing the role of quinolones in the management of neutropenic patients are under way. Zahn Mund Kieferheilkd Zentralbl, 1990, 78(3), 247 - 51 {The bacteriology of normal wound healing following tooth extraction with special reference to anaerobic microorganism diagnosis}; Stiebe B et al.; In 10 patients with indication to tooth extraction swaps from the microbiotopes "sulcus/gingival pocket", "root canal", "socket" and "extraction wound 2 and 7 days after extraction" were investigated bacteriologically . The anaerobic-aerobic mixed flora with predominance of anaerobes verified in the microbiotopes "sulcus/gingival pocket", "socket" and "extraction wound 2 days after extraction" was identically . The flora of the root canal was distinguished by a smaller amount of microbes with predominance of aerobes . In the 7 days old extraction wound only single aerobes could be verified whereas anaerobes were missed totally. Drugs Exp Clin Res, 1990, 16(9), 461 - 7 Pharmacology of cefminox, a new bactericidal cephamycin; Watanabe S et al.; Cefminox is a new cephamycin antibiotic possessing a D-amino acid moiety derived from D-cysteine at the C-7B side chain . Cefminox is active against a wide range of bacteria, especially Gram-negative and anaerobic bacteria . Cefminox shows excellent in vivo efficacy (ED50) which is higher than would be expected from its in vitro activity (MIC) . Moreover, cefminox possesses more potent activity in suppression of bacterial regrowth than other cephems . These phenomena are surmised to be caused by strong bactericidal activity which is attributed to a dual action mechanism. Drugs Exp Clin Res, 1990, 16(9), 445 - 9 Antimicrobial activity of E-4441, a representative azetidine quinolone; Esteve M et al.; E-4441 is a third-generation difluoroquinolone characterized by the presence in position 7 of an azetidine ring, disubstituted in position 3 by amine and methyl groups . E-4322 is another difluoroquinolone which differs from the former in having a 3-acetidinol substitution in position 7 . E-4441 shows satisfactory levels of activity, both in vitro and in vivo, its activity against G(+) aerobic bacteria and anaerobic bacteria being generally notable. Chirurgie, 1990, 116(4-5), 401 - 3 {Antibiotic prophylaxis in abdominal surgery}; Rotman N; In order to compare the efficacy of antibiotic therapy using Cefalozin or Cefotaxime, 3,137 patients operated with an abdominal approach were included into a multidepartmental prospective study by lot . The patients were distributed into 4 levels according to the degree of intraoperative contamination and to the risk factors they presented . The patients in each level were distributed by lot into three treatment groups: 1) Cefalozin, 2) Cefotaxime, 3) no treatment . The antibiotics were delivered perioperatively in 3 doses of 1 g every eight hours . The patients having had colic surgery or operated for peritonitis were excluded from the study . The number of intestinal wall abscesses was significantly lower in the treated groups, except in level 3 (contaminated surgery) . The percentage of postoperative peritonitis was twice lower in the treated groups than in the control group . There was no difference between the treated groups . The patients included in the treated groups were given significantly less antibiotics than the patients of the control group . As far as costs are concerned, antibiotic prophylaxis with Cefalozin is effective in all procedures of abdominal surgery in which the degree of contamination by anaerobes is low. Z Med Lab Diagn, 1990, 31(8), 445 - 52 {The direct detection of volatile fatty acids by gas chromatography in microbiological diagnosis}; Socolowsky S et al.; The gas chromatographic analysis of volatile fatty acids (VFA) is of great significance in the diagnosis of anaerobes and anaerobic infections, respectively . The ether extraction commonly used for this purpose is relatively consuming in time and material . In this relation, the presented method of detection of VFA in the aqueous phase directly shows essential simplifications but has a lower sensitivity . Therefore, this method cannot replace the ether extraction to investigate broth cultures of anaerobes for taxonomical purposes . But it enables the determination of VFA with sufficient sensitivity in clinical materials of patients . Herewith, the detection of acetic acid only indicates an infection without anaerobes if the concentration is higher than 20 mg/100 ml . On the contrary, a high correlation exists between the detection of n-butyric acid as well as isovaleric acid and the cultural isolation of anaerobic microorganisms. Braz J Med Biol Res, 1990, 23(3-4), 333 - 5 Blood glucose changes in the blue crab Callinectes sapidus Rathbun on transfer from sea water to air; Santos EA et al.; Intertidal decapods regulate their blood glucose with a significant but transitory (60 min) increase upon exposure to atmospheric air, and this has been considered to be an adaptative response related to the almost complete lack of the Pasteur effect in facultative anaerobes . In these animals we would not observe an increase in substrate availability to cope with the small amount of energy furnished by anaerobic pathways but rather a general metabolic depression . However, this hypothesis has never been tested by conducting similar experiments with infralittoral species . For this reason, groups of five Callinectes sapidus were transferred from sea water to atmospheric air and their blood glucose levels were determined 15, 30, 60, 120 and 240 minutes afterwards . Glucose levels increased gradually from 16.41 +/- 4.45 mg/100 ml to 127.18 +/- 33.40 mg/100ml (mean +/- SEM) . The linear relationship between time of exposure and glucose levels suggests that intertidal and infralittoral species present different mechanisms of blood glucose regulation. Perit Dial Int, 1990, 10(1), 97 - 8 Peritonitis following colonoscopy in a peritoneal dialysis patient; Ray SM et al.; A 65-year-old woman on continuous ambulatory peritoneal dialysis (CAPD) developed blood-tinged dialysate and bacterial peritonitis following a colonoscopic polypectomy . She grew multiple anaerobic organisms in her dialysate despite antibiotic prophylaxis with vancomycin and gentamicin prior to the procedure . This case confirms the need for broad spectrum antibiotic prophylaxis prior to colonoscopic procedures, especially if polypectomy is planned . The antibiotic chosen should cover anaerobes as well as gram-positive and gram-negative enteric organisms . We suggest the use of ampicillin, clindamycin, and an aminoglycoside antibiotic for this prophylaxis. Biodegradation, 1990, 1(1), 1 - 7 Fermentative degradation of dipicolinic acid (pyridine-2,6-dicarboxylic acid) by a defined coculture of strictly anaerobic bacteria; Seyfried B et al.; Degradation of dipicolinic acid (pyridine-2,6-dicarboxylic acid) under strictly anaerobic conditions was studied in enrichment cultures from marine and freshwater sediments . In all cases, dipicolinic acid was completely degraded . From an enrichment culture from a marine sediment, a defined coculture of two bacteria was isolated . The dipicolinic acid-fermenting bacterium was a Gram-negative, non-sporeforming strictly anaerobic short rod which utilized dipicolinic acid as sole source of carbon, energy, and nitrogen, and fermented it to acetate, propionate, ammonia, and 2CO2 . No other substrate was fermented . This bacterium could be cultivated only in coculture with another Gram-negative, non-sporeforming rod from the same enrichment culture which oxidized acetate to CO2 with fumarate, malate, or elemental sulfur as electron acceptor, similar to Desulfuromonas acetoxidans . Since this metabolic activity is not important in substrate degradation by the coculture, the basis of the dependence of the dipicolinic acid-degrading bacterium on the sulfur reducer may be sought in the assimilatory metabolism. Eur J Clin Microbiol Infect Dis, 1989 Dec, 8(12), 1111 - 6 Quinolone antibacterial agents for the treatment of genitourinary tract infections; Babinchak TJ et al.; The fluoroquinolones have expanded the therapeutic options available for the treatment of genitourinary tract infections . Their ease of oral administration, favourable pharmacokinetics, low incidence of adverse reactions, and broad spectrum of in vitro activity against aerobic and facultative organisms make them especially suitable for treating bacteriuria, particularly when pathogens are resistant to other available oral agents . Their efficacy has also been established in the treatment of prostatis, gonorrhea and chancroid . They have lower in vitro activity against chlamydia, ureaplasma and anaerobes, and their role in the treatment of non-gonococcal urethritis, vaginitis and acute pelvic inflammatory disease is less well established. Aust N Z J Surg, 1989 Dec, 59(12), 953 - 7 Design and trial of a metronidazole loading dose regimen for patients undergoing emergency surgery; Ioannides-Demos LL et al.; A dosing regimen for administration of metronidazole to patients undergoing emergency surgery was designed using pharmacokinetic data . Computer estimates of the pharmacokinetic parameters from normal volunteers were used to determine a loading dose protocol that would achieve plasma metronidazole levels above 6.2 micrograms/mL, that is, above the minimum inhibitory concentration (MIC) of most pathogenic anaerobic bacteria, at the time of surgery . The protocol aimed to identify the minimum intravenous metronidazole dose in combination with a rectal suppository regimen . This was calculated to be a 1 g (two 500 mg) metronidazole rectal suppository dose administered when the decision to operate was made, followed by a 200 mg intravenous dose at the induction of anaesthesia if the time to surgery was within 1-8 h . This protocol was tested in 10 patients undergoing emergency abdominal/pelvic surgery . All patients in the trial were found to have levels well above the MIC at the time of surgery (mean = 17.06 micrograms/mL, s.d . = 4.76) . It is concluded that appropriate use of metronidazole suppositories can minimize intravenous dosage requirements for metronidazole under conditions of emergency loading as well as elective surgery. J Clin Microbiol, 1989 Dec, 27(12), 2637 - 9 Controlled comparison of a new Becton Dickinson agar slant blood culture system with Roche Septi-Chek for the detection of bacteremia and fungemia; Reimer LG et al.; Two commercially available agar slide blood culture systems, Septi-Chek (Roche Diagnostics, Div . Hoffmann-La Roche Inc., Nutley, N.J.) and VACUTAINER agar slant (Becton Dickinson {BD} Vacutainer Systems, Rutherford, N.J.), were compared in 5,628 paired blood cultures from adult patients . The systems were inoculated with equal volumes (5 ml) of blood . There was no statistically significant difference between the two systems in the overall recovery of clinically important microorganisms; however, significantly more Escherichia coli (P less than 0.05) organisms were detected in the Septi-Chek system . Concurrently, significantly more contaminants (P less than 0.001) also were present in Septi-Chek bottles . When microorganisms grew in both systems, there was no significant difference in the time to recovery of important organisms, except that anaerobes were detected more quickly in the BD system . This study suggests that the BD VACUTAINER agar slant is an acceptable alternative to the Septi-Chek system for routine blood cultures. Pediatr Clin North Am, 1989 Dec, 36(6), 1551 - 69 Modern assessment of tonsils and adenoids; Brodsky L; Modern assessment of the tonsils and adenoids is based on an appreciation of new concepts pertaining to the pathogenesis of tonsil and adenoid disease . Recognition of the emergence of beta-lactamase-producing and encapsulated anaerobic bacteria in the tonsils and adenoids should lead to a reconsideration of present therapeutic recommendations for antibiotic therapy in infectious tonsil and adenoid disease . The performance of a precise history, use of a standardized physical examination, and judicious use of laboratory evaluation are all necessary for appropriate patient management and improved communication between the pediatrician and otolaryngologist . Thus, appropriate recommendation for tonsillectomy and adenoidectomy will enhance their benefits, and the result will be happier and healthier children. Oralprophylaxe, 1989 Dec, 11(4), 127 - 30 {Microbiological findings of subgingival plaque during long-term experimental gingivitis in humans}; Brecx M et al.; During six month of abolished oral hygiene and concomitant development of gingivitis, the buccal subgingival microbiota was studied by darkfield microscopy as well as by cultural methods . Five dental students gave written informed consent and participated in this trial . In darkfield microscopy there was a slow reduction in the proportion of coccoid forms concomitant with an increase in the proportion of rods, while spirochetes were rarely detected during the entire experimental period . However, the cultural data revealed a decrease of the Gram-positive facultative and an increase of the Gram-negative anaerobic microorganisms after 6 months of abolished oral hygiene . The bacteriological data show, that in buccal sites--even after 6 months of abolished oral hygiene--the subgingival microflora reflects a population typical only for an initial lesion. Antimicrob Agents Chemother, 1989 Dec, 33(12), 2137 - 9 Susceptibility of anaerobic bacteria to ALP 201; Nord CE et al.; The activity of ALP 201 against 350 strains of anaerobic bacteria was determined by an agar dilution method . Its activity was compared with those of piperacillin, cefoxitin, imipenem, clindamycin, metronidazole, and chloramphenicol . ALP 201 and imipenem were the most active agents tested . Based on these results, ALP 201 appears to be a promising antimicrobial agent for anaerobic infections and warrants further clinical investigations. Vet Microbiol, 1989 Dec, 21(2), 139 - 46 Preliminary study of the anaerobic bacteria isolated from subgingival plaque from sheep; McCourtie J et al.; A preliminary study was made to determine the genera of cultivable anaerobic bacteria which could be isolated from subgingival plaque of sheep . Samples were taken from 10 sheep on farms with a known record of broken mouth periodontitis . For assessment of the sampling technique, samples were also taken from freshly exposed tooth roots in killed sheep . The bacteria isolated on several selective and non-selective media were identified to genus level by a combination of Gram reaction, colony morphology and gas chromatographic analysis of volatile and non-volatile fatty acid metabolic end products . At least 10 different genera were isolated and these findings are discussed in relation to the bacteriology of human periodontitis and recent studies of sheep broken mouth periodontitis. Eur J Clin Microbiol Infect Dis, 1989 Dec, 8(12), 1064 - 7 Susceptibility of anaerobic bacteria to the new streptogramin RP 59500 in vitro; Nord CE et al.; The activity of the new streptogramin RP 59500 in vitro was determined against 380 strains of anaerobic bacteria by an agar dilution method and compared with that of pyostacine, piperacillin, cefoxitin, imipenem, clindamycin, metronidazole and chloramphenicol . RP 59500 and imipenem were the most active agents tested . On the basis of these results, RP 59500 appears to be a promising antimicrobial agent for treatment of anaerobic infections, further clinical investigations being warranted. Gynecol Oncol, 1989 Nov, 35(2), 233 - 5 Response of lower genital tract flora to external pelvic irradiation; Gordon AN et al.; Endocervical and vaginal cultures were obtained every week from patients undergoing external pelvic irradiation for gynecologic malignancy . Gram-positive aerobes accounted for 52 to 56% of isolates, gram-negative aerobes accounted for 15 to 16%, and anaerobes accounted for 29 to 32% of all isolates prior to therapy . No significant changes occurred during or after completion of radiation for the group . In individual patients, however, over 50% of organisms found on initial culture were no longer present on completion of external therapy. Indian J Med Res, 1989 Nov, 89, 435 - 8 Biotypes of Gardnerella vaginalis isolated from non-specific vaginitis patients in Bombay; Pandit DV et al.; The incidence