Anaerobes

J Reprod Med, 1988 Jun, 33(6 Suppl), 574 - 8
Implications of beta-lactamase-inhibitor combinations; Jones RN; Ticarcillin disodium/clavulanate potassium and other beta-lactamase inhibitor/penicillin combinations have been recognized recently as broad-spectrum drugs that have a major role in chemotherapy for serious surgical sepsis . Their spectrum of activity allows the economical substitution of ticarcillin disodium/clavulanate potassium for anaerobe-active cephalosporins and for the traditionally used combination of clindamycin and an aminoglycoside . Indeed, the ticarcillin disodium/clavulanate potassium spectrum was judged to be broader than that of the other agents while maintaining comparable or superior clinical efficacy and safety . The beta-lactamase inhibitor combinations have also proven their economical application to the prevention of infections after trauma and elective surgery, although those indications have not been well accepted . The timing seems to be right for the expanded use of these combinations in order to lower therapeutic and prophylactic costs . This concept is concurrent with the critical assessment of the cost effectiveness, safety and usable spectrum of older therapeutic regimens . However, some of the traditional nonpenicillin treatment modalities must be maintained for those patients with a penicillin allergy.

J Reprod Med, 1988 Jun, 33(6 Suppl), 584 - 7
Ticarcillin disodium and clavulanate potassium in the treatment of post-cesarean-section endomyometritis; Sanders CV Jr et al.; The combination of ticarcillin disodium/clavulanate potassium is a potent, irreversible inhibitor of beta-lactamase that is active against a broad spectrum of gram-positive and -negative bacteria, which often are found in the polymicrobial infection of postcesarean endomyometritis . Eighty-four randomly chosen women with postcesarean endomyometritis received 3 g ticarcillin disodium plus 100 mg clavulanate potassium intravenously every six hours . The drug was discontinued after patients were afebrile and asymptomatic for 72 hours . The mean duration of therapy was 4.7 days . A clinical cure was achieved in 56 of the 70 evaluable patients (80%); 14 were clinical failures . Six of the 70 patients (9%) were bacteremic . One hundred eighty-five aerobic bacteria and 109 anaerobic bacteria were isolated . Of the 96 aerobic isolates tested, 75 (78%) were beta-lactamase positive, as were 68 of the 78 anaerobic isolates (87%).

Clin Obstet Gynecol, 1988 Jun, 31(2), 423 - 34
The role of the newer antimicrobial agents in obstetrics and gynecology; Dinsmoor MJ et al.; The new antibiotics include interesting compounds--extended-spectrum cephalosporins and penicillins, combinations of older antibiotics plus beta-lactamase inhibitors, and new classes such as the monobactams and fluoroquinolones . In addition to extended spectrums, some of these compounds offer more favorable kinetics, less toxicity, or decreased cost . Several general conclusions might help place this array of new antibiotics in a useful clinical perspective . The newer antibiotics discussed here are no more effective than what is currently used . However, several have very good in-vitro activity against pelvic pathogens and are reasonable single-agent therapy in mild to moderate postpartum and postoperative infections . These antibiotics include cefoxitin, cefotetan, and piperacillin . Although moxalactam has good activity, its use is limited by concerns regarding bleeding disorders . Cefotaxime and cefoperazone have somewhat less favorable spectra, especially against anaerobes, yet in limited clinical trials are as effective as those cited above . Penicillin/beta-lactamase inhibitor combinations are currently being evaluated and appear to be reasonable choices . Although imipenem has an excellent in-vitro spectrum, it should probably be reserved for resistant cases . Aztreonam offers an alternative to gentamicin . However, in view of its greater cost, its use should be limited to patients in whom renal toxicity is a concern . For serious infections, combination therapy with clindamycin and gentamicin is our preference . For pelvic inflammatory disease, none of the agents is recommended as sole therapy due to the lack of coverage for chlamydia and frequent suboptimal coverage for anaerobes . Many of these agents have been effective for prophylaxis, but none has been shown to be superior to the older, less expensive agents such as cefazolin . Although many are effective in single doses, it is also likely that cefazolin is equally effective as a single dose . In addition, while most of the newer antibiotics are resistant to beta-lactamases themselves, they may induce their formation . This may ultimately result in limitations to the use of the relatively inexpensive prophylactic antibiotics.

Br J Clin Pharmacol, 1988 Jun, 25(6), 761 - 5
Pharmacokinetics of intraperitoneal teicoplanin in patients with chronic renal failure on continuous ambulatory peritoneal dialysis; Bonati M et al.; The pharmacokinetic profile of teicoplanin, a new glycopeptide antibiotic active against Gram-positive aerobic and anaerobic bacteria, is described in five patients with end-stage renal disease on continuous ambulatory peritoneal dialysis (CAPD) . A single 3 mg kg-1 dose was given intraperitoneally in the dialysate during a 6 h dwell time . The drug appeared in the plasma within 15 min at 1.00-0.28 mg l-1 (mean +/- s.d . = 0.70 +/- 0.45) in all five subjects, and peak serum concentrations ranged from 5.53 to 2.80 mg l-1 (4.84 +/- 1.43) at 6 h . Approximately 70% (71 +/- 12) of teicoplanin was absorbed from the peritoneal dialysis fluid during a single 6 h dwell time . The rate constant for peritoneal transfer (lambda d) averaged 0.318 h-1 and the half-life (t1/2 lambda d) was 2.18 h . Further values were serum elimination half-life 114-173 h; total body clearance 263-532 ml h-1; steady-state volume of distribution 68-93 l . This drug profile closely agrees with data reported after intravenous injection in patients on CAPD and suggests that teicoplanin has bidirectional exchange characteristics through the peritoneal membrane, although transfer from the systemic circulation to peritoneal fluid is consistently low . Instillation of teicoplanin in CAPD fluid may be a useful route of administration for treatment of peritonitis and exit site infections in CAPD patients.

Eur J Clin Microbiol Infect Dis, 1988 Jun, 7(3), 384 - 7
Evaluation of modified trypticase soy broth versus supplemented peptone broth in the detection of bacteremia and fungemia; Reimer L et al.; In vitro, 1.2% gelatin counteracts the inhibition of growth of bacterial species by sodium polyanetholsulfonate in blood culture media . Additionally, 1% yeast extract has been used to promote bacterial growth . We compared the performance of supplemented peptone broth and Trypticase soy broth, both of which contained sodium polyanetholsulfonate, gelatin and yeast extract . Trypticase soy broth with gelatin and yeast extract inhibited (p less than 0.001) and delayed growth, especially of gram-positive (p less than 0.01) and gram-negative (p less than 0.005) anaerobic bacteria . Although the recovery of organisms usually inhibited by sodium polyanetholsulfonate was similar in supplemented peptone and Trypticase soy broths, supplemented peptone broth clearly was superior in the recovery of other organisms commonly found in blood cultures.

Appl Environ Microbiol, 1988 Jun, 54(6), 1575 - 80
Isolation and characterization of a temperate bacteriophage from the ruminal anaerobe Selenomonas ruminantium; Lockington RA et al.; A temperate bacteriophage was obtained from an isolate of the ruminal anaerobe Selenomonas ruminantium . Clear plaques that became turbid on further incubation occurred on a lawn of host bacteria . Cells picked from a turbid plaque produced healthy liquid cultures, but these often lysed on storage . Mid-log-phase liquid cultures incubated with the bacteriophage lysed and released infectious particles with a titer of up to 3 X 10(7) PFU/ml . A laboratory strain of S . ruminantium, HD-4, was also sensitive to this bacteriophage, which had an icosohedral head (diameter, 50 nm) and a flexible tail (length, 140 nm) . The bacteriophage contained 30 kilobases of linear, double-stranded DNA, and a detailed restriction map was constructed . The lysogenic nature of infection was demonstrated by hybridization of bacteriophage DNA to specific restriction fragments of infected host genomic DNA and by identification of a bacteriophage genomic domain which may participate in integration of the bacteriophage DNA . Infection of S . ruminantium in vitro was demonstrated by two different methods of cell transformation with purified bacteriophage DNA.

Am J Surg, 1988 May 31, 155(5A), 5 - 10
Newer cephalosporins: lessons to be learned from clinical trials in intraabdominal infections; Bumgardner GL et al.; Recent clinical trials testing the efficacy of newer cephalosporins in intraabdominal infections lack a number of the study design criteria proposed by Solomkin et al . Nevertheless, these trials all support the use of these newer cephalosporins in the treatment of intraabdominal infections . These newer agents demonstrate increased in vitro antimicrobial activity against potential aerobic pathogens, which suggests that they may be used in combination with an antianaerobic drug in the treatment of intraabdominal infections . Therefore, agents including cefotaxime, cefoperazone, ceftazidime, cefuroxime, ceftriaxone, and aztreonam may be chosen in place of the standard aminoglycoside . Previous studies have demonstrated the necessity of both aerobic and anaerobic coverage in empiric therapy of intraabdominal infections . Cefotetan, ceftizoxime, cefoxitin, moxalactam, mezlocillin, and piperacillin all have in vitro activity against aerobes and anaerobes (including B . fragilis), thus, these agents have a potential as monotherapy for acute intraabdominal infections in otherwise healthy patients . Directed combination chemotherapy or perhaps imipenem alone is recommended for persistent peritonitis and intraabdominal infections in immunocompromised hosts.

Obstet Gynecol, 1988 May, 71(5), 723 - 6
The role of infection in the etiology of preterm birth; Toth M et al.; The hypothesis that infection induces or is a precursor to preterm birth or premature rupture of the membranes was examined in a prospective study of 193 randomly selected pregnant women . We investigated the prognostic significance of factors that suggest infection of the uterine cavity before pregnancy, such as a history of pelvic inflammatory disease, a history of intrauterine contraceptive device (IUD) use, multiple sex partners, and the presence of antisperm antibodies, in relation to premature rupture of the membranes and preterm birth . Sexual activity, a potential vehicle for bacterial exchange, was also charted throughout pregnancy via monthly interviews . We performed immunologic tests on each patient and obtained cultures of the cervix for aerobic and anaerobic bacteria and chlamydia at the first visit, occurring at six to 14 weeks' gestation, and again at 36 weeks . The results suggest that infection may indeed play a causative role in premature rupture of the membranes or preterm birth . A strong correlation was found between preterm birth and both a history of pelvic inflammatory disease (P = .004) and a history of IUD use (P = .0015) . Amnionitis was associated with the presence of immunoglobulin G (IgG) antisperm antibodies (P = .02), as well as with a history of pelvic inflammatory disease (P = .0006) . There was also a correlation between premature rupture of the membranes and a history of multiple sex partners (P = .02) . This collective evidence implicates preexisting infection of the uterine cavity as a predisposing factor in premature rupture of the membranes, preterm delivery, and amnionitis.

APMIS, 1988 May, 96(5), 464 - 70
Determination of susceptibility of anaerobic bacteria to beta-lactam antibiotics by a tablet diffusion test; Jansen JE et al.; A standardized tablet diffusion test and a reference agar dilution test was evaluated for susceptibility testing of anaerobic bacteria to beta-lactam antibiotics . 74 freshly isolated anaerobic bacteria and three control strains (Cl . perfringens ATCC 13124 B . fragilis ATCC 25285, B . thetaiotaomicron ATCC 29741) were tested . The in vitro activities of 7 beta-lactam antibiotics were compared with metronidazole and clindamycin . Most active were metronidazole and clindamycin . Cefoxitin had the best activity of the beta-lactam antibiotics, whereas piperacillin and carbenicillin had good activities . High resistance rates were found for penicillin, ampicillin, cefuroxime and cefotaxime . MIC on control strains fell well within range set by the National Committee for Clinical Laboratory Standards (NCCLS) . Correlation between MIC and inhibition zone diameters was generally good . Tablet diffusion can be used to divide anaerobic bacteria into three susceptibility categories . In addition all bacterial strains were tested for production of beta-lactamase by a nitrocefin tube test . Beta-lactamase production by the nitrocefin test indicated reduced sensitivity to beta-lactam antibiotics.

J Clin Microbiol, 1988 May, 26(5), 919 - 22
Evaluation of substrates for radiometric detection of bacteria in blood cultures; Bopp H et al.; Various 14C-labeled substrates were evaluated for their potential use in blood culture media . These uniformly labeled compounds were added to hypertonic and anaerobic formulations of modified Columbia broth and compared with analogous BACTEC media with the BACTEC 460 . Different bacterial species gave significant growth indices when 2.0 microCi of labeled glucose, glutamic acid, aspartic acid, arginine, or formate was used alone or in combinations in the experimental media . The combination of glucose, glutamic acid, and sodium formate was selected, and simulated blood cultures with representative aerobic, facultative, and anaerobic bacteria and a yeast were compared with BACTEC vials . Under these conditions, the experimental media often became positive several hours earlier than the BACTEC vials and usually produced higher growth indices.

Can J Microbiol, 1988 May, 34(5), 696 - 9
Influence of aerobic microorganisms upon virus survival in soil; Hurst CJ; Survival of human poliovirus type 1 in a sandy loam soil appeared to be deleteriously influenced by aerobic microorganisms . This effect was determined by comparing the survival of virus in soil under four different possible combinations of aerobic versus anaerobic (H2-CO2) atmosphere and sterile versus nonsterile condition . Storage of samples was done in humid chambers to prevent soil desiccation . The effect attributed to aerobic microorganisms was measurable and statistically significant at all three incubation temperatures used in the study (1, 23, and 37 degrees C), with the increase in inactivation rate attributable to aerobic microorganisms generally being two to threefold . No comparable effect was observed to occur for anaerobic microorganisms under the sets of conditions employed in the study.

Methods Find Exp Clin Pharmacol, 1988 Apr, 10(4), 231 - 7
Use of alveolar macrophages in antianoxic drug studies; Cazin M et al.; Alveolar macrophages are able to adapt their energy metabolism to very difficult survival conditions . Gaseous phase culture is adaptable to alveolar macrophages because it reproduces in vitro conditions very similar to in vivo conditions . It is easy to modify the incubation gas composition for hypoxia and anaerobiosis . Metabolic changes and cell injury were evaluated in three studies carried out after 24 hr of gaseous phase culture in normoxia and in anaerobiosis with a possible treatment with 0.01 microgram/ml vincamine: 1) ATP content assay by bioluminescence, the witness of cell vitality which decreases significantly in anaerobiosis; 2) Lactate assay which shows the metabolism derivation towards the anaerobic pathways; and 3) Tritiated deoxyglucose (DOG) incorporation, which shows glucose requirements after hypoxic incubation, maintaining or recovering a certain level of energetic activity . This incorporation greatly increases after anaerobic culture . Vincamine has no activity in normoxia . The three parameters are not significantly different from control, but in anaerobiosis, vincamine reveals an interesting protective effect . ATP content decreases under treatment and DOG incorporation increases . This demonstrates that vincamine is able to maintain cell metabolic activity for a longer period of time after the beginning of hypoxic trial . Cells can better use their energy storage and the metabolic pathways which enable them to restore themselves, thanks to vincamine treatment . It has been shown that cell membrane integrity was preserved by tests using cytochalasin B . DOG was not incorporated by cells treated with cytochalasin B after 24 hr of anaerobic culture and normally incorporated by control cells.(ABSTRACT TRUNCATED AT 250 WORDS)

Gut, 1988 Apr, 29(4), 473 - 82
Response of the jejunal mucosa of dogs with aerobic and anaerobic bacterial overgrowth to antibiotic therapy; Batt RM et al.; Dogs with naturally occurring aerobic or anaerobic bacterial overgrowth have been examined before and after antibiotic therapy in order to assess reversibility of damage to the jejunal mucosa . Histological changes in peroral jejunal biopsies were relatively minor before and after treatment, but sucrose density gradient centrifugation revealed specific biochemical abnormalities that responded to antibiotic therapy . Aerobic overgrowth was initially associated with a marked loss of the main brush border component of alkaline phosphatase activity; this recovered following treatment, suggesting that aerobic bacteria may cause reversible damage to the hydrophobic region of the brush border membrane . In contrast, anaerobic overgrowth was initially associated with a marked reduction in brush border density, indicative of a considerable fall in the glycoprotein-to-lipid ratio of the membrane . Density increased from 1.17 to 1.21 g/ml after antibiotic therapy, consistent with recovery from this relatively severe damage to the brush border caused by anaerobic bacteria . Reductions in soluble and peroxisomal catalase activities which could compromise mucosal protection against free radicals in dogs with aerobic overgrowth, and a loss of particulate malate dehydrogenase activity indicative of mitochondrial disruption in dogs with anaerobic overgrowth, were also reversed after treatment . These findings indicate that aerobic and anaerobic bacterial overgrowth can result in contrasting but potentially reversible damage to the jejunal mucosa which would not be detected by conventional investigative procedures.

Gastroenterology, 1988 Apr, 94(4), 915 - 22
Role of nitrite and nitrate as a redox couple in the rat colon . Implications for diarrheal conditions; Roediger WE et al.; Colonic levels of nitrite and circulating levels of nitrate are elevated in subjects with chronic diarrhea . The role of colonic epithelial cells in oxidation-reduction of nitrite and consequent control of nitrite and nitrate levels is unknown . Isolated rat colonocytes and isolated loops of colon were used to study oxidation and reduction of nitrate and nitrite . Colonocytes oxidized nitrite to nitrate at a rate of 162 +/- 33 nmol/min.g (dry wt) (n = 6) over 0-20 min, a value increased by addition of 5 mM glucose and 1 mM nicotinamide adenine dinucleotide (p = less than 0.01), but not altered by antibiotics . Nitrite oxidation correlated linearly with the dry weight of isolated colonocytes (r = 0.92), indicating a cellular reaction . Nitrite was absorbed at a rate of 0.28 nmol/min.cm2 (n = 9) from the colonic lumen, which reflected 74% absorption of the available nitrite . Of the absorbed nitrite, 14.3% reappeared in the colonic lumen as nitrate . Colonocytes may be important in oxidizing nitrite to nitrate, thus preventing excess nitrite from entering into the circulation and returning some nitrate to the colonic lumen for respiration by anaerobic bacteria . The interaction of nitrites and colonocytes deserves further study with regard to the oxidation-reduction of nitrite and to the development of colonic neoplasia in chronic diarrheal conditions.

Epidemiol Infect, 1988 Apr, 100(2), 271 - 8
A microbial culture system for use in remote field environments; Grimmond TR; Field studies of human flora carried out in remote environments are often compromised by problems associated with media, equipment or cargo limitations . For the International Biomedical Expedition to Antarctica an anaerobic culture system was developed based on sealed vials, pre-reduced anaerobically sterilized media, antibiotic selective media and compact processing equipment . The system proved simple to use in a harsh environment and gave results comparable with standard plate and roll-tube techniques . No problems with dehydration, contamination or oxidation were encountered . Furthermore, the system preserved viability of primary isolates for up to 6 months of storage.

Minerva Med, 1988 Apr, 79(4), 325 - 6
{Anaerobic vaginosis}; Garavelli PL et al.; The incidence of sexually transmitted diseases has increased in recent years . Anaerobic vaginosis, caused by Gardnerella vaginalis and anaerobic bacteria after subversion of the normal vaginal flora has only recently been the subject of specific studies using improved laboratory techniques.

Aktuelle Traumatol, 1988 Apr, 18(2), 84 - 6
{Concentration of metronidazole in bones}; Hahn F et al.; Bone and serum concentrations of metronidazole were determined in 16 patients receiving a single dose of metronidazole before total hip replacement . The patients gave written informed consent to the procedure . Bone specimens were taken during the operation . Metronidazole was determined in serum and bone by high-performance liquid chromatography (HPLC) . 30 to 85 minutes after i.v . infusion of 0.5 g metronidazole (infusion period 20 min.) concentrations in bone ranged from 3 to 25 mg/l . Metronidazole appears suitable for treatment of mixed infections of bone by anaerobes with proven sensitivity . Metronidazole should always be given in combination with another suitable antibiotic.

J Int Med Res, 1988 Mar-Apr, 16(2), 98 - 106
Decontamination of the oral cavity . Effect of six local anti-microbial preparations in comparison to water and parafilm as controls; Matula C et al.; Six preparations (four liquid and two solid) were tested in a double-blind crossover design for their anti-bacterial effect on aerobic and anaerobic bacteria in saliva of 12 volunteers . The four liquid preparations contained either tyrothricin, hexetidine, hydrogen peroxide or ethanol and were tested against a rinse with water as control . The two solid preparations, in the form of lozenges, contained tyrothricin in doses of 4 or 10 mg and were tested against parafilm . A single rinse with either tyrothricin or hexetidine resulted in a significant reduction of aerobic and anaerobic bacteria in saliva which lasted for the whole 1 h observation period and was considerably more effective than hydrogen peroxide or ethanol . Similar results were seen with the solid preparations . The lozenge containing 10 mg tyrothricin was the most effective and was the only formulation capable of reducing oral aerobic bacterial counts by a factor of approximately 100.

Scand J Gastroenterol, 1988 Mar, 23(2), 229 - 36
Microbial flora and bile acid metabolism in patients with an ileal reservoir; Go PM et al.; Bacterial flora of ileum effluent and bile acid metabolism were investigated in 11 patients 11-44 months after construction of a Kock's continent ileostomy . Bacteriologic investigation showed significantly more microorganisms per millilitre (p less than 0.01) and a more colon-like flora--that is, anaerobic microorganisms (p less than 0.001)--in ileum effluent of continent ileostomy patients than in ileum effluent of patients with a conventional ileostomy . The reabsorptive capacity of the reservoir mucosa was tested by direct introduction of a radioactively labelled conjugated bile acid, 23-75Se-25-homotaurocholic acid (SeHCAT), into the ileal pouch . After 4 h, 90% of the SeHCAT activity had been reabsorbed from the reservoir . Quantitative and differential analysis of bile acids in the ileum effluent showed unconjugated and predominantly primary (88%) bile acids, suggesting a minimal influence of bacterial flora on bile acid metabolism . Moreover, total bile acid loss appeared to be within normal limits.

Pathol Biol (Paris), 1988 Mar, 36(3), 203 - 8
{Application of the diagnostic ability coefficient to the comparison of 3 identification miniaturized systems for identifying anaerobic bacteria}; Bollet C et al.; The authors compare the performances of three identification systems for anaerobic bacteria . The computation of diagnosis ability coefficient (Descamps and Veron) made it possible to classify these systems to identify a batch of eighty strains coming from pathologic samples . The results are very close . This study shows profile catalogues' short coming and the disadvantages of their use which appears to be insufficiently critical . Every-day practice of these supplementary tests and the use of gas-liquid chromatography seem necessary to identify completely the anaerobic bacteria of the studied batch.

Infect Dis Clin North Am, 1988 Mar, 2(1), 203 - 20
The lumpy jaw . Cervicofacial actinomycosis; Lerner PI; Cervicofacial actinomycosis is a unique polymicrobic infection of endogenous origin, displaying a highly variable clinical course, ranging from an acute, suppurative lesion to a chronic fibrotic process more suggestive of a malignancy . Lesions advance with total disregard for tissue planes, producing burrowing sinus tracts to the skin or mucosal surfaces, which often discharge sulfur granules, colonies of Actinomyces species cemented together by host phosphatase activity . The diagnosis is quite elusive when proper studies (anaerobic culture, careful tissue examination and fluorescent antibody stains) are not undertaken in a timely fashion . Most cases respond well to a prolonged course of antimicrobial therapy . Some patients require excision of fibrotic lesions or persistent sinus tracts . Penicillin G is considered the agent of choice on the basis of extensive clinical experience; tetracycline, erythromycin, and clindamycin are effective as alternative agents.

Schweiz Med Wochenschr, 1988 Feb 27, 118(8), 257 - 63
{Sensitivity determinations for mycobacteria, fungi, anaerobic and other presumptive bacteria}; Burnens A et al.; The indications and methods for sensitivity testing of mycobacteria, fungi, anaerobes, and other fastidious bacteria are described in a study which is part of a series on sensitivity testing (this journal, 1984; 114: 1079-1086 and 1987; 117: 509-517) . Since these tests are rarely indicated and involve methodological problems, they are best performed by larger laboratories or by reference units.

Br J Oral Maxillofac Surg, 1988 Feb, 26(1), 62 - 9
Anaerobic bacteria in jaw cysts; Iatrou IA et al.; The bacterial flora of the fluid content of 54 cysts of the jaws with a history suggestive of infection were studied . Forty-seven of these cysts were subsequently considered to be infected and from 78.6% of these, positive bacterial cultures were developed . Of the bacterial strains 89.2% were anaerobes and only 10.8% were pure aerobes or facultative anaerobes . Microorganisms isolated from each specimen ranged from 1 to 4 bacterial species . Gram positive anaerobic cocci revealed to be the most frequent bacterial group (36.9%), followed by Gram negative anaerobic rods (29.8%), Gram positive aerobic cocci being the third most common group of the isolates (19.0%) . Antibiotic sensitivity tests of the isolated anaerobic cocci to a group of nine antibiotics revealed chloramphenicol and minocycline as the most effective . All anaerobic rods tested, were sensitive to metronidazole.

J Antimicrob Chemother, 1988 Feb, 21(2), 243 - 9
Reduction of oral flora with ciprofloxacin in healthy volunteers; Appelbaum PC et al.; The effect of a short course of ciprofloxacin on the oral microflora was examined in 16 healthy volunteers . Salivary specimens were collected before and after two 750 mg doses of ciprofloxacin administered 12 h apart . Salivary bacteria were identified to species level, and total quantitative colony counts were determined for each isolate . For all 16 subjects, treatment with ciprofloxacin led to a reduction in total bacterial colony counts; the mean inhibitory activity was 94.9% (range 79.6-99.9%) . Both aerobic and anaerobic bacteria were inhibited in every case: 72.5-99.9% for aerobes, mean inhibitory activity 93.5%; 75.0-99.9% for anaerobes, mean inhibitory activity 96.9% . Total counts were reduced by two or more logarithms in 75% of individuals for aerobes and anaerobes . All classes of bacteria were inhibited, with mean inhibitory activities ranging from 91.3% to 100% . These findings, together with the high salivary levels and low toxicity of ciprofloxacin, suggest clinical studies are required to assess its suitability in preoperative prophylaxis of patients undergoing head and neck cancer surgery.

Diabetes Care, 1988 Feb, 11(2), 111 - 5
Randomized controlled trial of topical hyperbaric oxygen for treatment of diabetic foot ulcers; Leslie CA et al.; The effect of 2 wk of topical hyperbaric oxygen (THO) treatment on the healing of diabetic foot ulcers without associated gangrene was evaluated in a prospective, controlled, and randomized manner in 28 patients . There were 12 patients in the THO group (group 1) and 16 in the control group (group 2) . Clinical management of the two patient groups was similar except for THO treatment in the group 1 patients . Clinical parameters, including age, sex, baseline fasting serum glucose levels, duration of diabetes mellitus, duration of foot ulcers, presence of peripheral neuropathy or arterial insufficiency, and evidence of osteomyelitis as determined by radiographs and/or radionuclide scans, were comparable in both groups of patients . No statistical differences (Student's t test) were seen in the number of microorganisms isolated from curettage cultures of the base of the ulcer at days 0, 7, and 14 of the study between groups 1 and 2 . In contrast to previous studies, there was a paucity of anaerobic microorganisms isolated from these foot ulcers without associated gangrenous changes . Ulcer areas were estimated by multiplying the maximum width by the maximum length in millimeters at days 0, 7, and 14 . Analysis of variance and Student's t test revealed progressive significant reductions in the ulcer areas in both groups when days 0, 7, and 14 were compared and in ulcer depths in both groups when days 0 and 14 were compared . However, such ulcer size changes did not differ statistically between the control and THO groups . A trend toward slower healing was observed in the THO group . Healing of diabetic foot ulcers was not accelerated by THO in this study.

Chemioterapia, 1988 Feb, 7(1), 20 - 3
Evaluation of in vitro activity of teicoplanin against recent clinical isolates; Nani E et al.; The in vitro antibacterial activity of teicoplanin, a new glycopeptide antibiotic, previously named teichomycin A2, has been compared to that of five other chemoantibiotics: netilmicin, clindamycin, rifampicin, enoxacin and vancomycin . The minimum inhibitory concentration (MIC) values against 588 gram-positive strains, 561 facultative aerobes and 27 anaerobes, recently isolated from clinical specimens, were evaluated . Teicoplanin showed the highest activity against all the tested strains, with a geometrical mean of the MICs (GMM), a MIC50 and MIC90 of 0.123, 0.12 and 0.5 micrograms/ml respectively.

Mol Biochem Parasitol, 1988 Jan 15, 27(2-3), 125 - 33
The purification and properties of two soluble reduced nicotinamide: acceptor oxidoreductases from Trichomonas vaginalis; Linstead DJ et al.; The occurrence of soluble reduced nicotinamide nucleotide:acceptor oxidoreductases has been reported in a number of strains of the oxygen-tolerant anaerobe Trichomonas vaginalis and other trichomonad species . The quantitatively more important enzyme in most strains of T . vaginalis is an NADH oxidase which produces water from the reduction of oxygen . This enzyme has been purified by a combination of gel filtration, chromatofocusing, Cibacron Blue chromatography and high pressure gel permeation chromatography . It is a monomeric protein with an estimated molecular mass from sodium dodecyl sulphate gel electrophoresis of 98 kDa; an isoelectric point of approximately pH 5.5 and a Km for NADH of 5.4 microM . The purified NADH oxidase is significantly inactivated during turnover under air (t1/2 3.65 min) and rapidly inactivated by microM levels of hydrogen peroxide . The NADPH-dependent minor activity requires a flavin . It has been partially purified by gel filtration and chromatofocusing . The apparent molecular mass of this enzyme is 36 kDa by gel filtration; it has an isoelectric point of approximately pH 5.2 and Km values for NADPH and FMN of 16.6 microM and 6.1 microM respectively . The product of oxygen reduction by this enzyme, using FMN as acceptor is hydrogen peroxide . The possible role of these two enzymes in the cell and their affinity with related enzymes from other organisms is discussed.

Biosystems, 1988, 21(3-4), 403 - 15
Ultrastructural description of a new chytrid genus of caecum anaerobe, Caecomyces equi gen . nov., sp . nov., assigned to the Neocallimasticaceae; Gold JJ et al.; Vegetative and reproductive stages of Caecomyces equi gen . nov., sp . nov . isolated from the horse caecum were examined by light and electron microscopy . This organism, which is similar to isolates known as Sphaeromonas communis, produces uniflagellate, uninucleate zoospores whose perikinetosomal structures, i.e . circumflagellar ring, spur, struts and scoop, are similar in many respects to those described in species of Neocallimastix . Microtubular roots extend basally from the spur and associate with hydrogenosomes and the nucleus . Another group of microtubules radiates laterally in a fan-shaped array close to the plasmalemma . Zoospores encyst, shedding their flagella with basal bodies, and germinate to diglobular thalli . Either coralloid or bulbous rhizoids form in plant material, but only the latter in axenic culture . Incipient zoospores are produced from a multinucleate eucarpic thallus and devlop within cleavage vacuoles containing flagella . An isolate from the cow rumen was found to be similar to C . equi in morphology and zoospore ultrastructure . On the basis of zoospore ultrastructure, we assign the new genus to the Neocallimasticaceae of the order Spizellomycetales . Organisms previously described as Sphaeromonas communis and Piromonas communis are renamed Caecomyces communis and Piromyces communis and assigned to the same family.

Biosystems, 1988, 21(3-4), 393 - 401
A rumen anaerobic fungus of the genus Neocallimastix: ultrastructure of the polyflagellate zoospore and young thallus; Webb J et al.; The ultrastructure of the zoosporic, rumen fungal anaerobe, Neocallimastix sp . R1, was determined and compared to that of the two known species of Neocallimastix . Zoospores of the new isolate were generally ovoid in shape, but without the waisted appearance of N . frontalis zoospores . They possessed similar organelles to the other two species, but with different localisation . The flagellar rootlet system was broadly similar to N . frontalis and N . patriciarum, however, a previously undescribed, large organelle was found to be associated near the kinetosomal apparatus in some Neocallimastix sp . R1 zoospores . Well developed flagella, complete with basal bodies, were observed in young thalli.

Rev Infect Dis, 1988 Jan-Feb, 10(1), 42 - 52
Anorectal infections in patients with malignant diseases; Glenn J et al.; Fifty-seven episodes of anorectal infection in 44 patients with malignant diseases primarily leukemia or lymphoma, have been retrospectively reviewed . Seventeen patients died in hospital, but only in seven cases was the anorectal infection a major contributing cause of death . The most important prognostic indicator of outcome was number of days of neutropenia during the infectious episode . Cultures obtained at the time of surgical drainage or by needle aspiration of the wound revealed multiple organisms in 26 of 29 instances, and anaerobic organisms were the commonest isolates . Anorectal infection was controlled in 28 (55%) of 51 treatment courses when antibiotics were the only treatment given . However, if the antibiotic regimen included both an aminoglycoside and an antibiotic with anaerobic coverage, control of infection was observed in 15 (88%) of 17 cases . There were 26 surgical procedures performed, with acceptable morbidity . Infection was controlled in 19 (73%) of 26 cases treated with surgery and antibiotics . The results support managing most of these infections initially with medical treatment, using an antibiotic regimen that includes an aminoglycoside and a specific drug against anaerobes . Surgery is recommended if there is obvious fluctuance, a significant amount of necrotic tissue evident, or progression of the infection locally or continued sepsis after an adequate antibiotic trial.

J Trauma, 1988 Jan, 28(1 Suppl), S215 - 6
Quantitative bacteriological study of the wound track; Tian HM et al.; Missile wounding was carried out to the hind legs of 46 mongrel dogs . The impact velocity was 730-1,570 m/s . The shot fragments were 0.44-1.03 gm in weight, 4.76 mm in diameter . The number of bacteria in devitalized muscle tissue, at 6, 12, and 24 hours after wounding, was studied by the usual bacteriologic methods . The studies showed that the number of aerobes in devitalized muscle was 10(3)-10(4)/gm tissue at 6 hr, 10(5) at 12 hr, and 10(5) at 24 hr after wounding . The number of anaerobes at 6 hours after wounding was 10(4)-10(5) . The number of bacteria in the devitalized zone was greater than that in the healthy zone . Bacterial cultures were always positive if the specimens were taken immediately after injury.

Laryngoscope, 1988 Jan, 98(1), 26 - 9
The use of topical oral antibiotics in head and neck prophylaxis: is it justified?
Kirchner JC, Edberg SC, Sasaki CT.
Systemic antibiotic therapy is widely used for prophylaxis in major head and neck surgery, but the efficacy of topical oral antibiotic therapy has not been adequately investigated . A pilot, placebo-controlled, double-blind crossover study using six healthy adult male volunteers was performed to assess the influence of topical clindamycin on oral flora . Samples of saliva were cultured for aerobic and anaerobic bacteria immediately before, and at 1- and 4-hour intervals after, rinsing the mouth with a solution of either placebo or clindamycin . Quantitative analysis demonstrated significantly reduced levels of both aerobic and anaerobic bacteria after use of the topical antibiotic at both the 1- and 4-hour intervals . It is postulated that topical clindamycin, by reducing concentrations of oral flora, may also reduce the incidence of regional infection following major upper aerodigestive tract surgery.

Ann Gastroenterol Hepatol (Paris), 1988 Jan-Feb, 24(1), 17 - 9
{Current aspects of digestive actinomycoses . Apropos of a case of hepatic actinomycosis}; Bouree P et al.; A case of hepatic actinomycosis is described in a patient with fascioliasis with Fasciola hepatica . The authors emphasize the abdominal sites of actinomycosis, specially appendix-cecum . Diagnosis, often difficult, is evoked before fistula with yellow granules in the pus . Definitive identification requires anaerobic culture . The treatment with lengthy antibiotic administration is efficient.

Rev Infect Dis, 1988 Jan-Feb, 10 Suppl 1, S193 - 6
Effect of new quinolones on the human gastrointestinal microflora; Nord CE; During the last years, the effect of new quinolones--ciprofloxacin, norfloxacin, ofloxacin, and pefloxacin--on the human microflora has been studied . This review article summarizes the published data concerning these studies . The results show that the oropharyngeal flora is only slightly or not at all affected by the quinolones . All new quinolones have a similar effect on the normal intestinal flora . The gram-negative aerobic flora is strongly suppressed during administration of quinolones, while the gram-positive flora is only slightly affected . The anaerobic microflora is almost not at all affected by the administration . The emergence of resistant bacterial strains is uncommon, although one investigation showed increased MIC values for anaerobes during ciprofloxacin administration . Replacement by yeasts or other inherently resistant microorganisms does not often seem to be a problem . High concentrations of the new quinolones are reached in feces; values between 100 and 2,200 mg/kg are reported . Since the new quinolones do not cause marked ecologic disturbances in the intestinal microflora, they may be suitable for selective decontamination in immunocompromised patients and for treatment of bacterial intestinal infections.

J Reprod Med, 1988 Jan, 33(1 Suppl), 101 - 6
Therapeutic considerations in postpartum endometritis; Fortunato SJ et al.; The physiologic changes of pregnancy and the puerperium and their effect on antibiotic therapy have not received widespread attention . Pregnancy is accompanied by multiple physiologic changes, including increased uterine weight, blood volume, extracellular fluid, endometrial blood flow and renal function changes . Those changes affect therapy for endometritis since it may take several weeks for a return to the pregravid state . Preeclampsia is associated with reductions in intravascular space, increased extravascular space from edema and impaired renal function . Postpartum uterine changes may also complicate drug therapy because of poor antibiotic perfusion . The ideal antibiotic for postpartum endometritis would achieve optimal uterine tissue levels, be administered infrequently, and have adequate activity against anaerobes and minimal toxicity.

Can J Surg, 1988 Jan, 31(1), 10 - 3
Cesarean section; Boyd ME; Cesarean section has become a common operation, but its complexity should not be underestimated . Often it must be done as an emergency without skilled assistants; at the same time the surgeon must deal with the maternal disorder that prompted the cesarean section and ensure the well-being of the fetus . Of further concern is the operative blood loss, which can be massive, and the postoperative morbidity, which is often high . The operative technique has evolved from an intraperitoneal vertical incision on the body of the uterus (classical cesarean section) to a near-complete reliance on a retroperitoneal transverse incision (lower segment cesarean section) . The historic reason for this change was the fear of peritonitis postoperatively . Present-day practice favours the lower segment operation and emphasizes the reduced operative blood loss and the more secure uterine scar as reasons for the choice . Operative complications (injury to the fetus, lacerations of the uterus and vagina) are the result of inadequate uterine incisions . The classical incision has the advantage of being easily extended and thus has a continued purpose . Postoperative febrile morbidity is attributed to endometritis; the mixed aerobic and anaerobic bacteria of the vagina are the causal organisms . Febrile morbidity can be prevented by antibiotics given prophylactically.

Ann Surg, 1988 Jan, 207(1), 108 - 11
Antibiotic use during major head and neck surgery; Johnson JT et al.; The appropriate use of prophylactic antimicrobial therapy in patients undergoing major contaminated surgery is an important issue for the head and neck surgeon . A series of five sequential, prospective, randomized, double-blind clinical trials of antibiotics for patients undergoing major contaminated oncologic head and neck surgery are reviewed and summarized . The information generated from the study of these 547 patients indicates that a number of drugs or drug combinations have similar efficacy when employed in adequate dosage . The bacteriologic spectrum of the prophylactic drug should include oral microflora, especially anaerobic bacteria . The administration of antibiotics effective against gram-negative aerobic bacteria may be unnecessary . Perioperative antibiotic administration should be initiated prior to surgery . To date, no evidence exists to support prolonged administration of antibiotics beyond the first 24 hours following surgery.

Arq Cent Estud Curso Odontol, 1988 Jan-1989 Dec, 25-26(1-2), 35 - 42
{Hydroalcoholic, prophylenic, hydropropylenic and glycerinated solutions of PMCF . Their use in endodontics . "In vitro" and "in vivo" study}; do Couto AB et al.; This work aims to test the efficiency of hand instrumentation allied to paramonochlorophenol dressing in cases of pulp necrosis, when this substance is diluted in water and alcohol, propylenoglicol and glycerin . Superficial pression and pH were verified to test them afterwards facing to bacteria that could be found in infected root canals and avaible to study in our bacteria lab . Solution more effective "in vitro" and of less cytotoxicity "in vivo" were selected to be employed in patients from the Dental Clinics at School of Dentistry--Federal University of Minas Gerais . It was concluded that: 1 . the relationship between cytotoxicity and bacterial activity was proportionally the reverse to superficial pression, except to Hydropropylenic solution of PMCF 5% and 10%; 2 . in the study with patients (40 cases) the growth anaerobic microorganisms were present in 97.5% of examined teeth; 3 . from solutions used for intracanal dressing hydroalcoholic solution of PMCF at 5% was the on which showed more effectiveness; 4 . studies must be carried out on glycerin solution of PMCF, to turn viable its employment in Endodontia.

Drugs Exp Clin Res, 1988, 14(10), 659 - 63
Clinical and microbiological effects of in vivo miocamycin therapy on oral infections and in surgical prophylaxis; De Luca M; Periodontal disease is a chronic irregularly progressing condition, posing many therapeutic problems . Difficulties arise particularly when antibiotic therapy is to be added to mechanical and surgical therapy because, in these cases, pharmacotherapy must be long-lasting . For such reasons the antibiotic of choice must have high activity but low toxicity, in order to avoid side-effects . Antibiotic therapy is also used in both marginal and apical acute phlogistic cases, so that the ideal compound should have high diffusion in gingival tissues and alveolar bone . Miocamycin shows all of these features and it can thus be considered the antibiotic of choice in the therapy of acute periodontal infections and in stomatological surgery . In this clinical study the efficacy of miocamycin has been evaluated in 120 cases of acute periodontal phlogosis and in the treatment of advanced periodontal diseases . Patients were microbiologically monitored for the identification of aerobic and anaerobic bacteria all through the study . In acute cases very good results were obtained, both concerning the reduction of pathological signs (94.1% of the cases) and the occurrence of side-effects (10% of the cases) . Among the patients who underwent surgical therapy, only 11 out of 80 showed small problems (slight fever and swelling).

Gynecol Obstet Invest, 1988, 25(1), 47 - 57
Descriptive light and electron microscopy of normal and clue-cell-positive discharge; van der Meijden WI et al.; In women with clue-cell-positive discharge (CCPD), light-microscopical examination of the wet mount suggests a preference of bacteria for certain vaginal epithelial cells (VECs) . To investigate this further, a light- and electron-microscopical study of patients and healthy controls was performed, with special emphasis on vitality and glycogen content of VECs and bacterial-epithelial cell interaction . Our study did not reveal morphologic differences between VECs of patients and controls . There was, however, a significant decrease in the percentages of vital and glycogen-containing VECs in CCPD (p less than 0.001), probably caused by an overgrowth of (anaerobic) bacteria . In CCPD vaginal bacteria preferably colonize vital VECs . This could account for the relatively low percentage of clue cells in this condition.

Orig Life Evol Biosph, 1988, 18(4), 397 - 407
Acetylene as a substrate in the development of primordial bacterial communities; Culbertson CW et al.; The fermentation of atmospheric acetylene by anaerobic bacteria is proposed as the basis of a primordial heterotrophic food chain . The accumulation of fermentation products (acetaldehyde, ethanol, acetate and hydrogen) would create niches for sulfate-respiring bacteria as well as methanogens . Formation of acetylene-free environments in soils and sediments would also alter the function of nitrogenase from detoxification to nitrogen-fixation . The possibility of an acetylene-based anaerobic food chain in Jovian-type atmospheres is discussed.

Clin Ther, 1988, 10(6), 747 - 60
Antibiotic susceptibility testing of anaerobic organisms using the agar dilution method: comparison of three techniques; Wexler HM et al.; Three currently used anaerobic susceptibility testing methods were compared: (1) the technique used at the Wadsworth Microbial Diseases Research Laboratory, (2) the technique listed as the reference standard by the National Committee on Clinical Laboratory Standards, and (3) the technique used at the Tufts New England Medical Center . Four-hundred-seventy anaerobic microorganisms, isolated from clinical specimens, were tested against cefoxitin, cefotetan, ceftizoxime, cefotaxime, ceftazidime, imipenem, and clindamycin . Significant differences were noted in mean inhibitory concentrations and percent susceptible at breakpoint among the three techniques used and varied with the antimicrobial agent and species tested.

Biosystems, 1988, 22(1), 67 - 81
The ultrastructure and possible relationships of four obligate anaerobic chytridiomycete fungi from the rumen of sheep; Munn EA et al.; Zoospores and vegetative growth phases of three cellulolytic rumen chytridiiomycetes, Piromonas, Sphaeromonas and NF1 have been examined by electron microscopy and compared with published and new data on Neocallimastix . The four genera have some 16 distinctive ultrastructural features in common, which collectively may be used to define the group . Some of the common features may individually be sufficient to distinguish these obligate anaerobes from facultative and aerobic chytridiomycetes . These features are the presence of hydrogenosomes at all stages of the life cycle, the presence in rhizoids and sporangia of characteristic crystals coated with hexagonal arrays of particles, and in zoospores the presence of distinct surface layers on the motility organelles and cell body respectively, the organization of the ribosomes into helical and globular arrays and the structures associated with the kinetosomes.

Biomed Pharmacother, 1988, 42(3), 213 - 5
Are anaerobic bacteria involved in peripheral vein catheter associated thrombophlebitis?
Collignon P, Sorrell T, Garret P.
While thrombophlebitis is a common complication of intravenous therapy, infection has been shown to be a cause of this problem in only a minority of cases . However, the methodology employed in the past would not have detected the anaerobes as a cause of this problem . As anaerobes are associated with thrombophlebitis in situations such as septic pelvic thrombophlebitis, we undertook a study to see if they might also be involved in thrombophlebitis associated with peripheral vein catheters . We prospectively studied 26 episodes of peripheral intravenous catheter associated thrombophlebitis . These catheters were all cultured under aerobic conditions by the semiquantitative technique on blood agar plates . In addition, they were promptly processed and cultured under optimal anaerobic conditions . In none of the episodes of thrombophlebitis were the catheters positive on semiquantitative culture . In addition, we did not show the presence of anaerobes on any of these catheters . We conclude that there is no evidence that anaerobes are associated with peripheral vein thrombophlebitis.

Basic Life Sci, 1988, 45, 211 - 22
Biodegradation of hydrocarbons in the environment; Atlas RM; Studies on the environmental fate of petroleum have demonstrated the nearly ubiquitous distribution of microorganisms that can metabolize hydrocarbons . The rates of degradation depend upon the concentrations of such microbes and upon the environmental characteristics of an oil-contaminated ecosystem . Given the appropriate environmental conditions, microorganisms effectively decontaminate, by their biodegradative metabolism, environments that have received petroleum pollutants . Higher-molecular-weight compounds, especially those with multiple condensed ring structures and with highly branched or substituted compounds, are relatively resistant to microbial attack . Despite the fact that a genetically engineered hydrocarbon degrader was the first organism ever patented and that seed cultures are produced by various commercial firms, enhanced biodegradation as a result of seeding generally has not been shown to be effective . Also, even though some anaerobes have now been demonstrated to be capable of hydrocarbon metabolism, hydrocarbons persist indefinitely in anoxic environments . Environmental modification, on the other hand, such as that achieved by aeration or fertilization with nitrogen and phosphorus, has been shown to enhance biodegradative removal of hydrocarbons . Having considered the various factors that influence the rates of hydrocarbon biodegradation, we are left with the question of what to do when environmental oil contamination occurs in order to minimize its persistence and thus its long-term effects . Clearly, treatment methods should enhance rather than inhibit the natural rates of oil biodegradation . In some cases, it is possible to modify environmental parameters to enhance rates of hydrocarbon biodegradation, but such methods are rarely undertaken . The translation of our scientific knowledge of hydrocarbon biodegradation into practical applications remains a major challenge . Specifically designed organisms are needed to degrade toxic aromatic components of refinery waste streams before environmental treatment . Specially designed reactors with specific microbial populations are also needed if oily sludges are to be degraded by biological means, either aerobically or anaerobically, in contained, environmentally safe reactors.

Zentralbl Mikrobiol, 1988, 143(3), 195 - 206
{Oxygen regulation of nitrogen metabolism in microorganisms}; Schauer F; Oxygen is one of the most important environmental factors for microorganisms . Many metabolic reactions of aerobic or facultative anaerobic bacteria are influenced by varying oxygen concentrations . A lot of enzyme reactions in respiration processes, catabolism, anabolism and gene expression depend upon oxygen . Other enzymes such as nitrogenase or hydrogenases can be inhibited by increasing oxygen levels . Also complex metabolic processes including anaerobic respiration and fermentations are regulated by oxygen . Finally toxic oxygen derivatives have to be eliminated by living cells to overcome damage of cell constituents . In this way also bacteria which are included into the nitrogen cycle in the nature are influenced by oxygen . The different strategies of microorganisms to protect their nitrogenases for oxygen inactivation and the regulation of dissimilative nitrate reduction by oxygen are demonstrated in detail.

Cell Tissue Res, 1988 Jan, 251(1), 87 - 93
Effect of live and heat-killed bacteria on the secretory activity of Paneth cells in germ-free mice; Satoh Y; Germ-free mice were given live or heat-killed facultative anaerobes, and the ultrastructure of ileal Paneth cells was quantitatively examined with special reference to secretory granules showing a bipartite substructure (central core and peripheral halo) . After administering live or heat-killed bacteria, there was a decrease in the area occupied by the cores of secretory granules in Paneth cells, and exocytosed core material was observed in the crypt lumen . There were no changes in the area occupied by the halo of secretory granules . None of the examined Paneth cells phagocytosed bacteria . It is concluded that certain bacteria may affect the secretion of antibacterial agents contained in the secretory granules of Paneth cells.

Antimicrob Agents Chemother, 1987 Dec, 31(12), 1989 - 93
In vitro susceptibilities of suspected periodontopathic anaerobes as determined by membrane transfer assay; Caufield PW et al.; Attempts to devise an antimicrobial approach to combating dentomicrobial infections such as periodontal diseases continue to be hampered by the lack of a relevant in vitro method for determining the susceptibility of suspected periodontopathogens to topically applied antimicrobial agents . Proposed here is a novel in vitro method called the membrane transfer technique, which acknowledges those aspects unique to localized pathogenic infections, particularly those associated with anaerobic bacteria . Bacterial lawns representing six suspected periodontopathic bacteria were prepared on membranes and then placed in contact with different concentrations of antimicrobial agents for 5 min . After incubation for 12 to 24 h, MBCs were determined with the aid of a tetrazolium chloride indicator . Four antimicrobial agents (chlorhexidine, iodine, stannous fluoride, and sodium fluoride) were used to test the applicability of the proposed in vitro method . MBCs were derived for each agent except sodium fluoride against all or most of the six bacterial strains tested . The proposed method may also be useful for examining the bactericidal action of topically applied antimicrobial agents against nonoral infections.

Am J Surg, 1987 Dec, 154(6), 631 - 5
Appendicitis in children: a systematic approach for a low incidence of complications; Stringel G; Four hundred fourteen appendectomies in children have been described . Acute nonperforated appendicitis was seen in 57.1 percent of the patients and perforated appendicitis in 18.6 percent . A histologically normal appendix was seen in 14.3 percent of the patients . In 31 of these patients, other pathologic abnormalities were found to account for the symptoms, thus the number of negative explorations was reduced to 7 percent . The average length of hospitalization was 5.3 days for patients with acute nonperforated appendicitis and 7.3 days for patients with perforated appendicitis . A protocol was followed which consisted of fluid resuscitation, preoperative and postoperative administration of antibiotics, and surgical exploration with appendectomy in all patients . No interval appendectomies were performed . The peritoneal cavity was not irrigated and the use of drains was avoided as much as possible . All wounds were closed primarily without wound drains . Topical cefamandole powder was used in all cases . Aerobic and anaerobic culture specimens were obtained in all cases from the peritoneal cavity and appendiceal stump . Twenty-eight different organisms were recovered, B . fragilis being the most common followed by E . coli . Excellent results were obtained without mortality and a less than 1 percent complication rate . There was a shorter period of hospitalization for patients with perforated appendicitis and a shorter period of antibiotic treatment.

South Med J, 1987 Nov, 80(11), 1343 - 6
Spontaneous bacterial peritonitis: variant syndromes; Conn HO; Spontaneous bacterial peritonitis (SBP), a fascinating disease that had been reported perhaps 50 times in varying guises over the preceding century, suddenly burst forth in the 1960s and was recognized in clusters of cases almost simultaneously in Paris, London, and West Haven, Connecticut . The spectrum of the disease has broadened . Initially, it was associated almost exclusively with alcoholic cirrhosis, but it has now been found in association with posthepatitic cirrhosis, cryptogenic cirrhosis, chronic active liver disease, and, occasionally, in biliary cirrhosis and cardiac cirrhosis . Recently, it has been reported in alcoholic hepatitis and acute viral hepatitis . It occurs occasionally in malignant ascites and in pancreatitis in the absence of cirrhosis . It is surprisingly common in disseminated lupus, in which it occurs relatively more commonly than in alcoholic cirrhosis . A similar syndrome, primary peritonitis, occurs frequently in children with nephrotic ascites . The clinical pattern of SBP has broadened . Initially it consisted of abdominal pain, fever, rebound tenderness, hypoactive bowel sounds, hypotension, encephalopathy, and cloudy ascites with large numbers of polymorphonuclear leukocytes in ascitic fluid . Each and every symptom, sign, and laboratory abnormality may be absent; indeed, the syndrome can be completely silent . Initially, the causative bacteria appeared to be almost exclusively enteric, but now the list of bacteria isolated in cases of SBP looks like a bacteriology textbook . Anaerobes are rare . Multiple organisms usually suggest nonspontaneous origin such as perforation or vasopressin induction . The differentiation between spontaneous and nonspontaneous bacterial peritonitis is crucial in the differential diagnosis . The great majority of cases of SBP develop in the hospital, 80% more than one week after admission . It is therefore a nosocomial disease that may be precipitated by procedure-induced bacteremia, gastrointestinal bleeding, or diarrhea, and it tends to occur in patients with low ascitic fluid protein (complement) concentrations and severe portal-systemic shunting.

J Urol, 1987 Nov, 138(5), 1254 - 5
Prostatic abscess owing to anaerobic bacteria; Brawer MK et al.; Abscess of the prostate is seen infrequently . We report a prostatic abscess owing to anaerobic bacteria in a 46-year-old man with a 10-year history of irritable voiding symptoms . Preoperative computerized tomography confirmed the diagnosis of prostatic abscess, which was treated with transurethral resection and broad-spectrum antibiotics.

J Bacteriol, 1987 Nov, 169(11), 5209 - 15
Purification and properties of protoporphyrinogen oxidase from an anaerobic bacterium, Desulfovibrio gigas; Klemm DJ et al.; Protoporphyrinogen oxidase has been solubilized from plasma membranes of Desulfovibrio gigas . The enzyme was purified to apparent homogeneity with single silver-stained protein bands on isoelectric focusing and sodium dodecyl sulfate-polyacrylamide gels . This protoporphyrinogen oxidase has a molecular weight (Mr) of 148,000 and is composed of three dissimilar subunits of Mrs 12,000, 18,500, and 57,000, which are held together by sulfhydryl bonds . Unlike other protoporphyrinogen oxidases, which use molecular oxygen as an electron acceptor, this enzyme does not couple to oxygen . The protoporphyrinogen oxidase donates electrons to 2,6-dichlorophenol-indophenol but not to NAD+, NADP+, flavin adenine dinucleotide, or flavin mononucleotide . The natural physiological electron acceptor of the protoporphyrinogen oxidase from D . gigas is unknown . By using 2,6-dichlorophenol-indophenol as the electron acceptor, the Km and Vmax values for oxidation of protoporphyrinogen were determined to be 21 microM and 8.38 nmol/min per 70 micrograms of protein, respectively . The catalytic rate constant, Kcat, was calculated to be 17.7 mol of protoporphyrin formed per mole of enzyme per min of incubation, and the Kcat/Km was 0.84 . Energies of activation were calculated from Arrhenius plots with 7,429 cal (ca . 31,080 J)/mol per degree below 10 degrees C and 1,455 cal (ca . 6,088, J)/mol per degree above 10 degrees C . Optimum enzyme activity was at 23 degrees C, and inhibition was observed with both N-ethylmaleimide and iodoacetamide.

Contraception, 1987 Nov, 36(5), 527 - 34
Bacterial flora of the cervix in women using an intrauterine device; Haukkamaa M et al.; The cervical bacterial flora of 18 healthy, parous, sexually active women was analysed before, and 3-5 months after insertion of a copper-releasing intrauterine device (IUD) and after long-term use of an IUD for 3-5.5 years in another nine women . No significant differences were found in the number of aerobic bacteria isolated before or after IUD insertion or after long-term use of an IUD . In contrast to aerobic bacteria, significantly more anaerobes were isolated in the cervix of women having used an IUD for several years when compared to those using barrier contraception with a condom . None of the women had clinical signs of pelvic infection and a cervical bacterial flora rich in anaerobes can be regarded as a normal finding in healthy sexually active women using an IUD for contraception.

Aust Vet J, 1987 Nov, 64(11), 343 - 6
Metronidazole for the treatment of bovine pyometra; Stephens LR et al.; Metronidazole, an antibiotic with specific activity against anaerobic bacteria, was assessed as a treatment for bovine pyometra . A preliminary experiment with metronidazole-neomycin was followed by an experiment in which metronidazole-ampicillin was compared with povidone iodine . Each treatment was given as a single intrauterine infusion . The success of therapy was judged by clinical examination, bacteriological examination before and after treatment and, in the second experiment, by post treatment reproductive performance . Before treatment 45 of the 84 cows in both experiments were infected with a mixture of anaerobic and aerobic bacteria, 23 cows were infected with aerobes alone and significant bacteria were not isolated from 16 cows . Complete bacteriological and clinical cures were achieved in 23 of 32 cows treated with metronidazole-neomycin, 15 of 32 cows treated with metronidazole-ampicillin and 1 of 20 cows treated with iodine . When only those cows with mixed anaerobe/aerobe infections were considered, complete cures occurred in 12 of 17 cows treated with metronidazole-neomycin, and 11 of 16 cows treated with metronidazole-ampicillin, but none of the 12 cows treated with iodine . Twenty-two of 29 cows treated with metronidazole-ampicillin conceived after treatment (mean 51.4 days), while 9 of 18 cows treated with iodine conceived (mean 58.7 days) . Statistically, metronidazole-ampicillin treatment produced significantly better clinical and bacteriological cure rates than iodine treatment (P less than 0.05), but the differences in reproductive parameters were not significant.

J Appl Bacteriol, 1987 Nov, 63(5), 455 - 7
Comparison of in vitro activity of niridazole, metronidazole and tetracycline against subgingival bacteria in chronic periodontitis; Wade WG et al.; Niridazole, metronidazole and tetracycline were compared for their activity against subgingival bacteria from patients with chronic periodontitis . Niridazole was consistently more effective than the other drugs against obligate anaerobes and exhibited some activity against facultative organisms . It was concluded that niridazole has potential for topical use in chronic periodontitis.

Acta Chir Scand, 1987 Nov-Dec, 153(11-12), 661 - 4
Pyogenic liver abscesses: have changes in management improved the outcome?
Falk KA, Angeras UJ, Friman VZ, Gamklou GR, Lukes PJ.
Pyogenic liver abscess is a serious condition with a high mortality rate . New diagnostic techniques have improved the diagnostic accuracy . Alternative therapeutic methods to open surgical drainage, such as percutaneous drainage and in certain cases antibiotics alone, are now available . Have changes in management of liver abscesses at our hospital improved the outcome? Two 5-year periods (I: n = 12; II: n = 14) were compared concerning diagnostic procedures, principles of treatment, and outcome . A shift from scintigraphy in the first period (I) to ultrasonography (US) in the second period (II) as prime diagnostic procedure was obvious . In I open surgical drainage dominated . 4/12, major surgical risks, were treated by anti-aerobic drugs alone, and died . In II US-guided percutaneous drainage was performed in 7/14, together with antibiotics active against aerobes as well as anaerobes, without complications . 4/14 were treated by an antibiotic combination alone and only 3/14 were treated by open surgical drainage . The change in management during these two periods has resulted in improved diagnostic and therapeutic routines as demonstrated by reduction in mortality rate.

Appl Environ Microbiol, 1987 Nov, 53(11), 2671 - 4
Anaerobic bacteria that dechlorinate perchloroethene; Fathepure BZ et al.; In this study, we identified specific cultures of anaerobic bacteria that dechlorinate perchlorethene (PCE) . The bacteria that significantly dechlorinated PCE were strain DCB-1, an obligate anaerobe previously shown to dechlorinate chlorobenzoate, and two strains of Methanosarcina . The rate of PCE dechlorination by DCB-1 compared favorably with reported rates of trichloroethene bio-oxidation by methanotrophs . Even higher PCE dechlorination rates were achieved when DCB-1 was grown in a methanogenic consortium.

Med Clin North Am, 1987 Nov, 71(6), 1169 - 75
Clindamycin; Klainer AS; Clindamycin is an excellent, well tolerated, effective antimicrobial agent that can be used clinically in the treatment of specific anaerobic infections as well as clinical situations when both S . aureus and anaerobes occur together.

J Clin Microbiol, 1987 Nov, 25(11), 2209 - 10
Three rapid methods compared with a conventional method for detection of urease production in anaerobic bacteria; Mills CK et al.; Three rapid methods (spot test, disk, and tube) for detecting urease production in anaerobic bacteria yielded results faster than the conventional method . The results were more consistent with the disk and tube methods than with the spot test . Blood agar plate growth gave more consistent results than growth from chopped-meat slants.

Medicine (Baltimore), 1987 Nov, 66(6), 447 - 56
Spontaneous bacterial peritonitis . A review of pathogenesis, diagnosis, and treatment; Wilcox CM et al.; Spontaneous bacterial peritonitis (SBP) is an increasingly recognized complication of cirrhosis with ascites . However, the presence of ascites from any cause appears to be a risk factor for this infection . The etiology of SBP is multifactorial, including derangements in the reticuloendothelial system, abnormalities of both the serum and ascitic fluid humoral immune systems, and systemic bacteremia . Gram-negative enteric pathogens are the etiologic agents in 70% of the cases; anaerobes are an uncommon cause . Fever and abdominal pain are the most common presenting symptoms . However, asymptomatic patients are being increasingly recognized . When SBP is suspected, paracentesis is indicated . An absolute polymorphonuclear leukocyte count greater than 500/mm3 is highly suggestive of SBP . Ascitic fluid lactate and pH may offer additional diagnostic assistance when the PMN count is ambiguous . Appropriate antibiotic therapy should be initially based on the centrifuged Gram stain of ascites as well as the patient's renal function . Mortality is substantial and appears to be related to the severity of the underlying liver disease.

J Clin Microbiol, 1987 Oct, 25(10), 2020 - 2
Comparison of two transport systems for recovery of aerobic and anaerobic bacteria from abscesses; Brook I; An evaluation of two commercially available swab transport systems, Port-A-Cul (PAC; BBL Microbiology Systems, Cockeysville, Md.) and Anaerobic Specimen Collector (ASC; Becton Dickinson Vacutainer Systems, Rutherford, N.J.), in the recovery of organisms from clinical specimens was done . Fifteen abscesses were drained, and swabs of their contents were placed in the transport systems until they were inoculated for detection of aerobic and anaerobic bacteria . The swabs were plated immediately after collection and after delays of 4, 24, 48, and 72 h . A total of 70 bacterial isolates, 47 anaerobes and 23 aerobes, were recovered from specimens inoculated immediately after collection . The survival of anaerobic bacteria was better in the PAC system than in the ASC system . This was evident as the length of delay in cultivation was extended . At 4 h, 46 anaerobic isolates were recovered in the PAC system, compared with 39 in the ASC system (P less than 0.1) . At 24 h, 45 isolates were recovered in the PAC system and 26 isolates were recovered in ASC (P less than 0.001); at 48 h, 40 were recovered in PAC and 15 were recovered in ASC; and at 72 h, 32 were recovered in PAC and 6 were recovered in ASC . There were no differences between the systems in the recovery of aerobic bacteria . These data demonstrate the usefulness of the PAC system in the recovery of anaerobes and the need for quality control of all transport systems for anaerobic bacteria.

Dis Colon Rectum, 1987 Oct, 30(10), 800 - 1
Treatment of pneumatosis coli with metronidazole . Endoscopic follow-up of one case; Jauhonen P et al.; A case of pneumatosis cystoides intestinalis in the large bowel with complete resolution after eight weeks of metronidazole treatment is reported . This symptomatic case, with an acute onset classified as the primary (idiopathic) type, became asymptomatic after a few days and was followed until complete endoscopic and radiologic resolution . No recurrence was noticed during 15-month follow-up . This lends support to the assumption that anaerobic bacteria contribute to the etiopathogenesis of this condition . The choice of metronidazole as an easy ambulatory therapy is encouraged.

Chemioterapia, 1987 Oct, 6(5), 341 - 5
Anti-mycoplasmal activity of a new macrolide: miocamycin; Furneri PM et al.; The object of this study was the evaluation of the activity of miocamycin and other macrolides (erythromycin and josamycin) against 61 Ureaplasma urealyticum, 1 Acholeplasma laidlawii and 21 aerobe mycoplasmas (M . pneumoniae, M . hominis, M . gallisepticum, M . mycoides) and anaerobe mycoplasmas (M . morale and M . salivarium) both clinically isolated and standard reference strains . The minimum inhibitory concentrations (MIC) values for miocamycin ranged between 0.00625 mg/l and 0.4 mg/l (ureaplasmas) and between 0.001 mg/l and 0.0625 mg/l (mycoplasmas, except M . hominis with 0.025 mg/l to 0.25 mg/l) . For erythromycin, the MIC values ranged between 0.19 mg/l up to 500 mg/l (ureaplasmas) and between 0.001 mg/l to 0.0625 mg/l (mycoplasmas, except M . hominis with 100 mg/l to 1000 mg/l) . MIC values for josamycin ranged between 0.03125 mg/l and 0.5 mg/l (M . pneumoniae only) . The sub-MIC treatment (carried out on human pathogenic mycoplasmas only) evidenced growth curve modifications and a decrease of the O2 uptake directly correlated to the drug concentrations.

Br J Obstet Gynaecol, 1987 Oct, 94(10), 979 - 84
Isolation of Gardnerella vaginalis in pure culture from the uterine cavity of patients with irregular bleedings; Kristiansen FV et al.; Hysterectomy was performed in three patients because of persistent irregular vaginal bleeding . Before the operation samples were taken from the cervical os for cultivation of Gardnerella vaginalis, yeasts, viruses, Chlamydia trachomatis, and aerobic and anaerobic bacteria . Immediately after the operation, the uterus was opened under sterile conditions and samples obtained from the isthmus and fundus of the uterine cavity were examined microbiologically . In all three patients G . vaginalis was grown in pure culture from the fundus . Serum antibody titres against G . vaginalis were significantly raised in all three patients, and histology revealed mononuclear cells in the endometrium . The isolation of G . vaginalis from the endometrium of patients with clinical and histological signs of inflammation and with antibodies to G . vaginalis in serum indicates that the organism may play a causative role in endometritis.

Eur J Clin Microbiol, 1987 Oct, 6(5), 575 - 8
Bacteria in bile of patients with bile duct inflammation; Kosowski K et al.; Bile samples taken intraoperatively from 100 patients with three different bile system diseases were subjected to bacteriological analysis . Statistically significant differences between the types of aerobic and anaerobic bacteria present in the bile were found.

Diagn Microbiol Infect Dis, 1987 Oct, 8(2), 95 - 100
Comparison of susceptibility results of anaerobic organisms determined by agar dilution method and Sceptor Anaerobe MIC/ID Micro Broth Dilution Panels; Hussain Z et al.; A commercial broth microdilution system (Sceptor Anaerobe MIC/ID, BBL) for susceptibility testing of anaerobic bacteria was compared to a reference agar dilution system . Of the 172 organisms tested, only 7% failed to grow sufficiently for testing in the Sceptor system . In 1,590 antibiotic/organism combinations, 86.7% of the Sceptor results were identical or within one doubling dilution of the reference system . In 91.9% of the cases, interpretation of the results was same in both systems . Two hundred and twelve MIC values, however, differ by greater than or equal to 2 log2 dilution from the reference system . Due to this reduced correlation in the actual MIC values with the reference results, further studies are warranted before the Sceptor system can be recommended for routine use.

Appl Environ Microbiol, 1987 Oct, 53(10), 2511 - 9
Transformations of chloroguaiacols, chloroveratroles, and chlorocatechols by stable consortia of anaerobic bacteria; Neilson AH et al.; Metabolically stable consortia of anaerobic bacteria obtained by enrichment of sediment samples with 3,4,5-trimethoxybenzoate (TMBA), 3,4,5-trihydroxybenzoate (gallate {GA}), or 5-chlorovanillin (CV) were used to study the anaerobic transformation of a series of chloroveratroles, chloroguaiacols, and chlorocatechols used as cosubstrates . Experiments were carried out with growing cultures, and the following pathways were demonstrated for metabolism of the growth substrates: (i) TMBA produced GA, which was further degraded without the formation of aromatic intermediates; (ii) GA formed pyrogallol, which was stable to further transformation; and (iii) CV was degraded by a series of steps involving de-O-methylation, oxidation of the aldehyde group, and decarboxylation to 3-chlorocatechol before ring cleavage . Mono-de-O-methylation of the cosubstrates occurred rapidly in the order 4,5,6-trichloroguaiacol greater than 3,4,5-trichloroguaiacol approximately 3,4,5-trichloroveratrole approximately tetrachloroveratrole greater than tetrachloroguaiacol and was concomitant with degradation of the growth substrates . For the polymethoxy compounds--chloroveratroles, 1,2,3-trichloro-4,5,6-trimethoxybenzene, and 4,5,6-trichlorosyringol--de-O-methylation took place sequentially . The resulting chlorocatechols were stable to further transformation until the cultures had exhausted the growth substrates; selective dechlorination then occurred with the formation of 3,5-dichlorocatechol from 3,4,5-trichlorocatechol and of 3,4,6-trichlorocatechol from tetrachlorocatechol . 2,4,5-, 2,4,6-, and 3,4,5-trichoroanisole and 2,3,4,5-tetrachloroanisole were de-O-methylated, but the resulting chlorophenols were resistant to dechlorination . These results extend those of a previous study with spiked sediment samples and their endogenous microflora and illustrate some of the transformations of chloroguaiacols and chlorocatechols which may be expected to occur in anaerobic sediments.

Antibiot Med Biotekhnol, 1987 Oct, 32(10), 764 - 7
{Method for demonstrating strict anaerobes in microbial associations}; Bazhenov LG et al.; A procedure for indicating strict anaerobes in microbial associations was developed . The indication is performed with two disks: aminoglycoside (amikacin, 10-micrograms disk) (A) and metronidazole aminoglycoside (metronidazole + amikacin, 5- and 10-micrograms disks respectively) (MA) . Colonies growing in zone A and absent in zone MA are considered to be strictly anaerobic . The procedure is characterized by high reliability: false positive results are practically not recorded and the frequency of false negative results does not exceed 5-10 per cent . The rate of detecting anaerobes in clinical materials is significantly increased (by 1-3 days) as compared to that with the use of the routine bacterial methods . The indication procedure markedly simplifies laboratory diagnosis of anaerobic infections at the account of clear differentiation of microorganisms grown on the primary plate and possible directed selection of anaerobic colonies for further investigation which excludes the necessity of rejecting or studying other colony types . This leads to economy of nutrient media and increasing labor productivity.

Dis Colon Rectum, 1987 Oct, 30(10), 786 - 9
Systemic Timentin is superior to oral tinidazole for antibiotic prophylaxis in elective colorectal surgery . University of Melbourne Colorectal Group; Contributions of anaerobic metabolism to pH regulation in animal tissues: theory; Institut fur Zoologie IV, Universitat Dusseldorf, FRGProton balance is analysed in relation to the anaerobic and aerobic metabolism of carbohydrates, carbonic acids, amino acids and fat by considering oxidation, carboxylation, decarboxylation and phosphorylation reactions, as well as the influence of ammonium, on the acid-base status of animal tissues . The functional role of the adenylates, phosphagens and inorganic phosphate in acid-base balance is investigated with respect to differences in the physicochemical properties of organic and inorganic phosphates . General principles are established for different anaerobic metabolic pathways in species from several phyla . It is concluded that proton release from the substrate, which is always involved in substrate-level phosphorylations, is essential for the mechanism of ATP formation . Anaerobic metabolism, which is characterized by incomplete oxidation of carbon chains and an accumulation of acidic groups, supports pH regulation in facultative anaerobes by minimizing the amount of accumulated protons . High levels of phosphagens mean high proton absorption during hydrolysis and an increase in the intracellular buffer value . Decarboxylation reactions in catabolic pathways are equivalent to proton consumption . The degradation of carbonic acids during anaerobiosis, therefore, contributes to pH regulation . Release of ammonia or ammonium ions in catabolism is also linked to the buffering of protons originating from the formation of carboxyl groups and net cleavage of ATP . Net disposal of amino groups or ammonium ions by transamination, reductive amination or ion exchange does not change this general picture . The proton, bicarbonate and CO2 turnover in metabolic pathways is discussed with respect to the interrelationships between pH and metabolic regulation.

Obstet Gynecol, 1987 Sep, 70(3 Pt 1), 365 - 8
Does extra-amniotic infection cause preterm labor? Gas-liquid chromatography studies of amniotic fluid in amnionitis, preterm labor, and normal controls; Iams JD et al.; Gas-liquid chromatography (GLC) was used to identify short-chain organic acid byproducts of bacterial metabolism in amniotic fluid from seven normal control patients, six women with overt amnionitis, and six preterm labor patients . Microbiologic culture for aerobic and anaerobic bacteria was also carried out . Positive GLC findings were generally associated with positive cultures, except in five of the preterm labor patients whose GLCs were positive despite negative cultures . The origin of the short-chain organic acids found in these women is unclear; extra-amniotic bacterial growth may explain this finding.

Antimicrob Agents Chemother, 1987 Sep, 31(9), 1434 - 7
In vitro activity of cefmetazole, cefotetan, amoxicillin-clavulanic acid, and other antimicrobial agents against anaerobic bacteria from endometrial cultures of women with pelvic infections; Ohm-Smith MJ et al.; The MICs of the new antimicrobial agents cefmetazole, cefotetan, and amoxicillin-clauvulanic acid were compared with the MICs of other antimicrobial agents against anaerobic bacteria from endometrial cultures from women with pelvic inflammatory disease or endometritis . The activity of cefmetazole was similar to that of cefoxitin and generally greater than that of cefotetan . Amoxicillin-clavulanic acid was generally more active than all cephamycins tested.

J Periodontol, 1987 Sep, 58(9), 594 - 601
The role of adjunctive Rodogyl therapy in the treatment of advanced periodontal disease . A longitudinal clinical and microbiologic study; Quee TC et al.; Several studies have indicated that the combination of metronidazole and spiramycin is synergistic against anaerobic bacteria and may be effective against oral infections . The present study sought to determine the efficacy and safety of a commercial preparation of these two antibiotics (Rodogyl) when used adjunctively in the treatment of advanced periodontal disease . In a double-blind parallel randomized trial, 56 patients (mean age = 44 years) with advanced periodontitis (50 of whom completed the study) were assigned to either the Rodogyl or placebo group . Both groups were thoroughly scaled and root planned for approximately 6 hours, with one group receiving Rodogyl for 2 weeks and the other a placebo . No other therapy was received during the study period . Two sites in each patient with probing depths of at least 7 mm were selected for study . Plaque level (P1I), gingival inflammation (GI), probing depth (PD), and attachment level (AL) were measured at baseline, 14 days, 1 month, and then at monthly intervals up to 6 months . Subgingival bacteria were monitored with dark-field microscopy . The development of resistant bacteria, as well as side effects to the medications, was also monitored . The Rodogyl group exhibited a greater gain in AL (0.67 mm) from the 2-month interval until the end of the study . Although this difference was statistically significant (P less than 0.05), it was not necessarily of biologic significance . There was a significantly greater decline in the proportion of spirochetes in the Rodogyl group at the 14-day interval, and this difference remained significant (P less than 0.05) at all study intervals . No difference in the proportion of motile organisms was observed.(ABSTRACT TRUNCATED AT 250 WORDS)

Wien Med Wochenschr, 1987 Aug 15, 137(14-15), 317 - 20
{Nonspecific urethritis}; Soltz-Szots J; The multiple etiology of non-gonorrhoic urethritis has been extensively investigated in the last few years . It has thus become possible to diagnose the separate forms and consequently treat them with a greater degree of accuracy and specificity . For exact diagnosis multiple and time consuming examinations are often necessary . Sometimes this can only be done in highly specialized laboratories . Among the agents triggering such an infection Chlamydia (30.9% of the cases of non-gonorrhoic urethritis), as well as mycoplasma, ureaplasma, anaerobic bacteria and herpes simplex viruses have gained particular significance . Whereas these infections very rarely lead to complications by ascension in men they can result in unpleasant and severe disease in women (salpingitis, infertility, newborn infection).

S Afr Med J, 1987 Aug 15, 72(4), 248 - 9
Efficacy of different antibiotics in the treatment of pelvic inflammatory disease; Burchell HJ et al.; A total of 40 patients with acute pelvic inflammatory disease (APID) were studied over a period of 7 months; one aim was to evaluate the use of different antibiotics in treatment . The most important findings were: (i) most patients had a polymicrobial aetiology for their APID; (ii) Chlamydia trachomatis and the anaerobic bacteria were the most common organisms encountered; and (iii) tetracycline plus metronidazole is probably the best combination therapy for APID.

J Reprod Med, 1987 Aug, 32(8), 618 - 9
Vulvar hematoma secondary to a human bite . A case report; Mathelier AC; A case of vulvar hematoma resulting from cunnilingus occurred in an alcoholic woman . Incision and drainage with debridement of devitalized tissues, systemic antibiotics covering both anaerobes and aerobes, and counseling are usually required for the optimal result in such cases.

Obstet Gynecol, 1987 Aug, 70(2), 187 - 90
Microbiologic and serologic studies of Gardnerella vaginalis in intra-amniotic infection; Gibbs RS et al.; Our objective was to investigate the role of Gardnerella vaginalis in intra-amniotic infection by use of comparative, quantitative cultures on selective media and by detection of maternal antibody response . Amniotic fluid was collected from patients with intra-amniotic infection and from matched control women . In addition to media for aerobes, anaerobes, and mycoplasmas, we used V agar-selective (Remel, Lenexa, KS) to isolate G vaginalis . Acute and convalescent maternal sera were collected and assayed for antibodies by a microenzyme-linked immunosorbent assay (ELISA) prepared against whole cells of G vaginalis . Gardnerella vaginalis was isolated in the amniotic fluid of 24 (28%) of the 86 patients with intra-amniotic infection, but this was not significantly different from the isolation rate in amniotic fluid of 86 matched controls (21%) . No patient exhibited G vaginalis bacteremia . The ELISA performed on paired sera of selected patients showed that 25 had intra-amniotic infection (eight G vaginalis-positive, 17 negative), and 18 were asymptomatic (seven G vaginalis-positive, 11 negative) . The amount of G vaginalis antibodies detected by ELISA in acute sera was similar in all four groups . Mean changes during convalescence were small (.053-.084 optical density units) and not significantly different . Although G vaginalis is found commonly in amniotic fluid of patients with intra-amniotic infection, the data do not support a pathogenic role for this organism; however, a facilitating role in polymicrobial infection cannot be excluded.

Int J Oral Maxillofac Surg, 1987 Aug, 16(4), 440 - 4
Acute cervico-facial actinomycosis; Nielsen PM et al.; Cervico-facial actinomycosis still occurs occasionally and should be included in the differential diagnosis of infectious processes in the jaws and the oral cavity . The typical actinomycosis-cases are clinically chronic in nature; however actinomycosis may be atypical with subacute or acute clinical manifestations . Among 37 cases of infectious processes in the jaws treated with extraoral incision between 1980 and 1985 in the Department of Oral Surgery, School of Dental Medicine, University of Berne, 3 (8%) were diagnosed as acute actinomycosis according to the following procedure . Prior to incision, pus was aspired under aseptic conditions . Presence of gram-positive branched filaments in the microscopically examined pus led to the suspicion of actinomycosis . This diagnosis was confirmed by cultivation of Actinomyces israelii using the anaerobic culture method, biochemical characteristics and gas-liquid chromatographic analysis of metabolic products . These 3 actinomycosis-cases were successfully treated by surgical removal of the suspicious foci and by administration of clindamycin per os for 16 days.

Nurs Times, 1987 Jul 22-28, 83(29), 44 - 5
Identifying vaginitis in general practice; Smail J; PIP: Clinicians conducted a study of 154 women who presented themselves at a health center of the University of Wales College of Medicine with symptoms of vaginitis . A nurse examined the vagina with a speculum to note the appearance of the cervix, the color and amount of discharge, and the presence of odor and inquired about soreness during the examination . The nurse took 3 endocervical swabs and 2 high vaginal swabs . Upon microscopic examination, any vaginal discharge with epithelial cells stippled with small coccobacilli indicated a possible Gardnerella vaginalis infection . Laboratory personnel identified G . vaginalis either alone or in combination with other organisms in 53% of the women . Those with G . vaginalis alone or in combination with anaerobes reported more symptoms than those women who had negative cultures . In addition, women with G . vaginalis alone and those G . vaginalis in combination with other organisms had more discharge, described as yellow and runny, than those with negative cultures . 77% of the women infected with G . vaginalis had a high cheese or fishy odor . 75% of the women with G . vaginalis came to the health center between 2-4 weeks or even longer after they 1st noticed symptoms . On the other hand, women who were infected with C . albicans presented to the health center within a week of the start of the symptoms . Clinicians had previously treated erroneously many of the women with G . vaginalis with an antifungal agent . These women should be treated with metronidazole or, if a yeast infection is also present, with an antifungal agent and metronidazole . All women who present themselves to a nurse or physician with vaginal symptoms should have a history taken, an examination, and vaginal discharge samples taken and evaluated in the laboratory .

J Am Vet Med Assoc, 1987 Jul 15, 191(2), 201 - 6
Bacterial overgrowth in the duodenum of dogs with exocrine pancreatic insufficiency; Williams DA et al.; Bacterial overgrowth (greater than 10(5) colony-forming units/ml duodenal juice) in the duodenum was demonstrated in 8 of 11 dogs with exocrine pancreatic insufficiency (EPI) . In 4 of these 8 dogs, the overgrowth included large numbers (greater than 10(4) colony-forming units/ml) of obligate anaerobic bacteria and was associated with decreased activities of several brush border marker enzymes and, in 2 dogs, with partial villous atrophy in the jejunum . Changes in the jejunal mucosa of the remaining dogs (with either no overgrowth or overgrowth of aerobic bacteria alone) were characterized by increased activities of some brush border disaccharides and of lysosomal hydrolases . One dog was euthanatized without treatment, at the owner's request . The response of 4 of the remaining 10 dogs treated with enzyme replacement alone was poor or suboptimal, and all of these 4 dogs had bacterial overgrowth . One of these dogs had an excellent clinical response when also given oxytetracycline orally for 14 days, but the other 3 dogs did not improve further in response to the same treatment . It was concluded that bacterial overgrowth in the duodenum is common in dogs with EPI and that, when such overgrowth includes large numbers of obligate anaerobes, there may be associated biochemical and morphologic abnormalities in jejunal mucosa . Functional disturbances related to abnormal intestinal microflora may be responsible for the failure of some dogs with EPI to respond fully to oral pancreatic enzyme supplementation without antibiotic therapy.

Eur J Biochem, 1987 Jul 15, 166(2), 447 - 52
Cloning and expression of the genes of two fumarate reductase subunits from Wolinella succinogenes; Lauterbach F et al.; The fumarate reductase complex of the anaerobic bacterium Wolinella succinogenes catalyzes the electron transfer from menaquinol to fumarate . Two structural genes coding for subunits of the enzyme have been cloned in Escherichia coli . The genes were isolated from a lambda EMBL3 phage gene bank by immunological screening and subcloned in an expression vector . The genes frdA and frdB, which encode the FAD protein (Frd A, Mr 79,000) and the iron-sulfur protein (Frd B, Mr 31,000) of the fumarate reductase complex, were cloned together with a W . succinogenes promoter . The gene order was promoter-frdA-frdB . The FAD protein and the iron-sulfur protein were expressed in the correct molar mass in E . coli from the clones . The identity of the frdA gene and the suggested polarity were confirmed by comparing the amino-terminal sequence of the Frd A protein with that predicted from the 5'-terminal nucleotide sequence of frdA . The frdA and frdB genes are present only once in the genome . A region downstream of frdB, possibly a gene encoding cytochrome b of the fumarate reductase complex, hybridizes with a second site in the genome.

Biochemistry, 1987 Jul 14, 26(14), 4219 - 27
8-Hydroxy-5-deazaflavin-reducing hydrogenase from Methanobacterium thermoautotrophicum: 1 . Purification and characterization; Fox JA et al.; The 8-hydroxy-5-deazaflavin (coenzyme F420) reducing hydrogenase from the obligate anaerobe Methanobacterium thermoautotrophicum delta H has been purified 41-fold to apparent homogeneity . The major active enzyme form is a high molecular weight aggregate of Mr ca . 800,000, composed of three subunits, alpha (Mr 47K), beta (Mr 31K), and gamma (Mr 26K) . The hydrogenase is purified aerobically in reversibly inhibited form, and conditions for anaerobic reductive activation with H2, high salt, thiols, and electron acceptors have been defined . The minimal species transferring electrons from H2 to coenzyme F420 appears to be an alpha beta delta (Mr 115K) complex . The tightly associated redox cofactors per 115K species are 0.6-0.7 nickel atom, 0.8-0.9 flavin adenine dinucleotide (FAD), and 13-14 iron atoms in iron-sulfur centers . The subunits have been separated by denaturing gel electrophoresis, which has permitted determination of amino acid composition, subunit N-terminal sequencing, and preparation of subunit-directed antibodies . There is iron associated with the alpha-subunit, but placement of the nickel and FAD has not been established.

J Int Med Res, 1987 Jul-Aug, 15(4), 205 - 11
Tissue and serum concentrations of amoxycillin and clavulanic acid in patients having reconstructive vascular surgery; Earnshaw JJ et al.; Fifteen patients received amoxycillin/clavulanic acid combination intravenously at anaesthetic induction as part of a three-dose schedule of antibiotic prophylaxis for vascular surgery . After 30 min, the mean serum concentration of amoxycillin was 39.9 mg/l and clavulanic acid was 9.3 mg/l . Mean amoxycillin tissue concentrations in fat, 5.1 mg/l; vein, 7.5 mg/l; and artery, 4.8 mg/l, were lower than serum values . Mean clavulanic acid concentrations were: fat, 0.7 mg/l; vein, 1.2 mg/l; and artery, 1.6 mg/l . At the end of surgery, the serum amoxycillin level was always greater than 6 mg/l and clavulanic acid greater than 2 mg/l, which were both still within the therapeutic range . Concentrations in fat had declined by the end of the surgery ranging from 0.76 to 5.2 mg/l for amoxycillin and from 0.03 to 0.6 mg/l for clavulanic acid, there being almost none detected in four cases . Serum and tissue concentrations of both compounds 30 min after injection were sufficient to inhibit the growth of 97% of pathogenic organisms recovered from the skin of 135 vascular surgical patients . In a few cases tissue levels of the compounds were below inhibitory concentrations for coliforms and anaerobes at the time of skin closure, although they were still effective against most Gram-positive organisms . Amoxycillin/clavulanic acid combination is suitable antibiotic prophylaxis for vascular surgery.

Am J Vet Res, 1987 Jul, 48(7), 1036 - 8
Actinobacillus suis-like organisms in horses; Jang SS et al.; Actinobacillus suis-like organisms have been recognized in equine specimens at the University of California Veterinary Medical Teaching Hospital since 1975 . The most common source (65%) of the organism was transtracheal washings . The organism was gram-negative, produced hemolysis on blood agar, and gave a positive reaction for oxidase, urease, o-nitrophenyl-beta-D-galactopyranoside, and esculin . Carbohydrate reactions were variable, consisting of 4 main patterns . Actinobacillus suis-like organisms were (90%) sensitive to therapeutic concentrations of amikacin, cephalothin, chloramphenicol, gentamicin, kanamycin, tetracycline, and trimethoprim-sulfamethoxazole . Other aerobic and anaerobic bacteria were recovered frequently with the organism.

Br Heart J, 1987 Jul, 58(1), 57 - 65
Infective endocarditis in children with congenital heart disease: comparison of selected features in patients with surgical correction or palliation and those without; Karl T et al.; The diagnostic and prognostic features of 44 episodes of infective endocarditis in 42 children with congenital heart disease were reviewed . Endocarditis occurred in 18 patients who had not had surgical correction or palliation of the defect (non-operated group) . There were 26 episodes in 24 patients who had been treated surgically (operated group) (16 open and eight closed cardiac operations) . Endocarditis occurred soon after open heart surgery in eight patients and as a late complication in the other 16 . It recurred in two patients (operated group) . Invasive monitoring and low cardiac output were consistent features in those patients who had endocarditis soon after open heart surgery whereas dental treatment was a common feature in non-operated cases and after closed cardiac operations . Late cases of endocarditis after open heart surgery had various microbiological features that were not typical of infection after dental problems . Gram positive infections occurred in non-operated patients and in those who had had closed cardiac operations . The group that had open heart surgery had infections caused by Gram positive, Gram negative, and anaerobic bacteria and fungi . Fever, anaemia, leucocytosis, and positive blood cultures were the only consistent findings . Vegetations were seen in nine of 12 patients at cross sectional echocardiography . All 12 (four non-operated, one closed, and seven open cases) needed acute surgical treatment . The mortality from infective endocarditis was 17% for non-operated cases, 0% for those who had had closed heart surgery, and 50% for those who had had open heart surgery . Infective endocarditis after open heart surgery differs from that in the other subgroups in terms of microbiology, source of infection, and outcome and its early diagnosis depends on a thorough investigation of minimal symptoms and signs.

Rev Infect Dis, 1987 Jul-Aug, 9(4), 737 - 42
Bacteremia with Anaerobiospirillum succiniciproducens; McNeil MM et al.; Anaerobiospirillum succiniciproducens is a motile, spiral anaerobic bacterium with bipolar tufts of flagella . Reports of clinical illness due to A . succiniciproducens are rare . In a retrospective review of anaerobic isolates referred to the Centers for Disease Control (CDC) from January 1, 1975, through January 31, 1986, isolates of A . succiniciproducens from the blood of 21 patients were identified . A single patient whose blood isolate had not been received at CDC was included in the review . These 22 patients were from 15 states . Their mean age was 58.6 years . Underlying disorders included alcoholism, atherosclerosis, malignancy, surgery, diabetes mellitus, and dental caries . Clinical features included gastrointestinal tract signs and symptoms in 17 (77%) of 22, fever greater than 38 degrees C in seven (37%) of 19, and leukocytosis of more than 10,000 cells/mm3 in 11 (58%) of 19 . Although 16 patients received antimicrobial therapy, its effect on outcome was unclear . A . succiniciproducens was reported to have contributed to the deaths of seven patients . Disorders predisposing patients to anaerobic infections may put them at increased risk for A . succiniciproducens bacteremia . The presence of antecedent gastrointestinal tract signs and symptoms suggests that the gastrointestinal tract might be the primary portal of entry.

Zentralbl Bakteriol Mikrobiol Hyg {A}, 1987 Jul, 265(3-4), 314 - 22
{Methodologic problems in the detection of indole formation by anaerobic pathogens}; Hohne C et al.; The demonstration of indole formation is of great value for the identification of pathogenic anaerobes . A reduction of the pH to values below the critical range of 5.1-5.3 in complex media 5.5 in simple testing substrates, respectively, which is caused by the presence of fermentable carbohydrates and will result in false-negative reactions . For this reason, the indol test should be performed with an adequate buffer capacity and an addition of fermentable carbohydrates should be avoided . Strains showing a false-negative reaction in the spot indole test can be reliably accounted for by means of the rapid test in buffered tryptophan solution described here without having to use additional anaerobic culture methods.

Antibiot Med Biotekhnol, 1987 Jun, 32(6), 449 - 53
{Etiological structure and antibiotic sensitivity of the causative agents of puerperal endometritis}; Voropaeva SD et al.; The study revealed the dominating role of aerobic-anaerobic microbial associations and in particular the specific role of anaerobic gram positive cocci in development of puerperal endometritis . The data suggested that a definite level of the uterus cavity contamination with microbes, not lower than 10(4)-10(5) CFU/ml or a large number of bacterial associates, not less than 3 was necessary for endometritis development . It was confirmed that pathogenicity of anaerobes increased in the presence of aerobic bacteria . It is concluded that quantitative methods for detecting the main causative agents of endometritis are needed . A set of antibacterial drugs for rational antibacterial therapy of puerperal endometritis is recommended.

Xenobiotica, 1987 Jun, 17(6), 685 - 96
The reduction of sulphinpyrazone and sulindac by intestinal bacteria; Strong HA et al.; 1 . Incubation of human or rabbit faeces with sulphinpyrazone gave greater reduction under anaerobic than under aerobic conditions . Reduction of sulindac by human faeces was more extensive than that of sulphinpyrazone . 2 . Growth of mixed cultures of intestinal bacteria in nutrient media containing antibiotics produced a marked inhibition in their ability to reduce sulphinpyrazone . Sulphide formation was inhibited by metronidazole and lincomycin for human faeces and by tetracycline for rabbit faeces/caecal contents . 3 . The formation of the sulphides of sulindac and sulphinpyrazone ex vivo was decreased in faeces from patients treated with metronidazole . Metronidazole, but not tetracycline, decreased the extent of reduction of sulphinpyrazone by rabbits in vivo . No reduction of either substrate occurred on incubation with ileostomy effluent . These data indicate that anaerobic intestinal bacteria are important in the reduction of these sulphoxide-containing drugs . 4 . However, when incubated anaerobically with over 200 strains of bacteria isolated from human faeces, sulphinpyrazone was reduced by most of the aerobic but not the anaerobic organisms . Sulindac was reduced more extensively by the same aerobes and by some anaerobes . 5 . The discrepancy between the apparent importance of anaerobes in vivo and in vitro may be due to their very large number present in the hind gut and to the production of an anaerobic environment suitable for the enzymic activity of other organisms, such as aerobes or facultative anaerobes.

J Antibiot (Tokyo), 1987 Jun, 40(6), 823 - 42
Synthesis, antimicrobial evaluation and structure-activity relationships within 23-modified derivatives of 5-O-mycaminosyltylonolide; Kirst HA et al.; A large series of C-23-modified derivatives of 5-O-mycaminosyltylonolide were synthesized, in which the C-23 hydroxyl group was replaced by halo, aryl ether or thioether, azido, amino or dialkylamino substituents via SN2 displacement reactions . The majority of derivatives possessed excellent in vitro activity against a variety of aerobic and anaerobic bacteria . While some of the compounds treated experimental infections in rodents by parenteral administration, none showed any significant efficacy or bioavailability after oral dosing . Novel rearrangement products were obtained from some of the reactions; these were identified as 13,23-cyclopropyl-12,22-exomethylene and 13,23-cyclopropyl-12-alkoxy derivatives.

Postgrad Med, 1987 Jun, 81(8), 141 - 7
Anaerobic bacteria . Their role in infection and their management; Finegold SM; Anaerobic bacteria are commonly involved in a number of common infections--especially aspiration pneumonia, intraabdominal infection, and a variety of female genital tract infections . Certain distinctive clinical features suggest the possibility of anaerobic infection; included are foul odor, infection in proximity to a mucosal surface, abscess formation, and gas in tissues or discharges . Treatment includes surgical management (debridement and drainage) and use of appropriate antimicrobial agents.

Br J Oral Maxillofac Surg, 1987 Jun, 25(3), 204 - 17
Osteomyelitis of the mandible in children--clinical presentations and review of management; Ord RA et al.; Four cases of osteomyelitis of the mandible in children are reported to illustrate the spectrum of presentation . A proliferative rather than a lytic bony response is usually seen due to attenuation of the causative organisms and the improved immunological status of children in Britain . The importance of penicillin-resistant organisms and anaerobes, early diagnosis by scintigraphy and the use of hyperbaric oxygen therapy are highlighted.

Microbiol Sci, 1987 Jun, 4(6), 164 - 8
Regulation of citric acid cycle genes in facultative bacteria; Spencer ME et al.; In a facultative anaerobe such as Escherichia coli the citric acid cycle is an inducible pathway rather than a constitutive pathway . In spite of intensive study at the enzymological and molecular biological levels many aspects of the cycle, including its regulation during the aerobic/anaerobic switch, are not fully understood.

Appl Environ Microbiol, 1987 May, 53(5), 1020 - 7
Growth inhibition of putrefactive anaerobe 3679 caused by stringent-type response induced by protonophoric activity of sorbic acid; Ronning IE et al.; The inhibitory effects of potassium sorbate on the bioenergetics, phenylalanine uptake, protein synthesis, and certain aspects of cell regulation were examined in putrefactive anaerobe 3679 . Undissociated sorbic acid appeared to act as a protonophore by lowering the intracellular pH and dissipating the proton motive force of the membrane . Sorbate inhibited the uptake of phenylalanine, decreased the rate of protein synthesis, and altered patterns of phosphorylated nucleotide accumulation, resulting in increased intracellular concentrations of GTP, ppGpp, and an unidentified compound (possibly pppGpp) . The addition of a noninhibitory amount of tetracycline released the inhibition of growth by sorbate . Based on these results, we concluded that the inhibition of putrefactive anaerobe 3679 by sorbate resulted from a stringent-type regulatory response induced by the protonophoric activity of sorbic acid.

J Bacteriol, 1987 May, 169(5), 2150 - 7
Physiological adaptations of anaerobic bacteria to low pH: metabolic control of proton motive force in Sarcina ventriculi; Goodwin S et al.; Detailed physiological studies were done to compare the influence of environmental pH and fermentation end product formation on metabolism, growth, and proton motive force in Sarcina ventriculi . The kinetics of end product formation during glucose fermentation in unbuffered batch cultures shifted from hydrogen-acetate production to ethanol production as the medium pH dropped from 7.0 to 3.3 . At a constant pH of 3.0, the production of acetate ceased when the accumulation of acetate in the medium reached 40 mmol/liter . At a constant pH of 7.0, acetate production continued throughout the entire growth time course . The in vivo hydrogenase activity was much higher in cells grown at pH 7.0 than at pH 3.0 . The magnitude of the proton motive force increased in relation to a decrease of the medium pH from 7.5 to 3.0 . When the organism was grown at pH 3.0, the cytoplasmic pH was 4.25 and the organism was unable to exclude acetic acid or butyric acid from the cytoplasm . Addition of acetic acid, but not hydrogen or ethanol, inhibited growth and resulted in proton motive force dissipation and the accumulation of acetic acid in the cytoplasm . The results indicate that S . ventriculi is an acidophile that can continue to produce ethanol at low cytoplasmic pH values . Both the ability to shift to ethanol production and the ability to continue to ferment glucose while cytoplasmic pH values are low adapt S . ventriculi for growth at low pH.

Arch Otolaryngol Head Neck Surg, 1987 May, 113(5), 514 - 5
Bacteriology in acute mastoiditis; Maharaj D et al.; During the period from July 1979 to December 1979, the bacteriology of 35 consecutive patients undergoing surgery for acute mastoiditis was studied . The patients' ages ranged from 3 to 13 years . All patients presented with a purulent otorrhea and a postauricular subperiosteal abscess and were subjected to a mastoidectomy within 12 hours of presentation . Specimens were obtained intraoperatively from the mastoid cavity and, using appropriate technology, were cultured for aerobic and anaerobic organisms . Bacteria were isolated from specimens of 32 patients (91.4%); specimens from three patients (8.6%) yielded no growth . Aerobes alone were cultured from four patients (11.4%); six patients' cultures (17.1%) yielded only anaerobes; and 22 patients' cultures (62.8%) had both aerobic and anaerobic organisms . Thus, anaerobes were cultured from a total of 28 patients (80.0%).

Drug Intell Clin Pharm, 1987 May, 21(5), 406 - 16
Antimicrobial prophylaxis of gastrointestinal surgical procedures and treatment of intraabdominal infections; Danziger L et al.; Antibiotic prophylaxis and treatment regimens ideally are selected on the basis of efficacy, safety, and cost . This review evaluates current, selected literature on antibiotic prophylaxis for colorectal surgery, presumptive antibiotic administration following penetrating abdominal trauma, and treatment of intraabdominal infections . Single-drug regimens with the newer, broad-spectrum agents are assessed and compared with combination regimens; specific regimens are recommended . Colorectal procedures require an antimicrobial agent with activity against both aerobes and anaerobes . Patients undergoing elective colorectal procedures can be adequately protected with an orally administered three-dose regimen of neomycin/erythromycin . Parenteral antibiotic administration is generally not necessary, but, cefoxitin is recommended for nonelective colorectal surgery . The risk of potential infectious complications following penetrating abdominal trauma without colonic perforation is less than with colonic perforation; however, antibiotic therapy that includes activity against aerobes and anaerobes is recommended for all types of penetrating abdominal trauma . Although cephalothin, cefamandole, or cefoxitin alone may be used in abdominal trauma without perforation of the colon, only cefoxitin is recommended as a single-drug alternative to the standard clindamycin/gentamicin regimen in trauma with colonic perforation . Single-drug therapy with cefoxitin or moxalactam can be used successfully as alternatives to the standard regimens of clindamycin/gentamicin or metronidazole/gentamicin in many patients with intraabdominal sepsis . Single-drug regimens reduce the risk of developing adverse effects and are cost-effective . However, if resistant organisms are suspected, or if the patient has been hospitalized for a prolonged period or has multiple organ failure, it may be necessary to supplement cefoxitin therapy with an antibiotic that will enhance coverage against gram-negative aerobes.

Pathol Biol (Paris), 1987 May, 35(5), 572 - 6
{Comparative activity of 9 beta-lactamines, clindamycin and metronidazole on strictly anaerobic bacteria}; Derriennic M et al.; The in vitro activities of amoxicillin, amoxicillin-clavulanic acid, piperacillin, cefoxitin, cefotetan, cefotaxime, cefmenoxime, ceftizoxime, latamoxef, clindamycin and metronidazole, were determined by agar dilution method for 196 clinical isolates of anaerobic bacteria . No metronidazole resistant strains could be found, 10% of tested strains were resistant to clindamycin . The majority of these strains was susceptible to amoxicillin-clavulanic acid and piperacillin; less than 10% were resistant to latamoxef, cefoxitin, cefotaxime and ceftizoxime; whereas 15 to 20% were resistant to amoxicillin, cefotetan and cefmenoxime.

Otolaryngol Clin North Am, 1987 May, 20(2), 259 - 72
The clinical microbiology of Waldeyer's ring; Brook I; The role of microorganisms in infections of Waldeyer's ring is reviewed . The agents involved are aerobic and anaerobic bacteria, viruses, chlamydia, fungi, parasites, and rickettsia . The therapeutic implications of the presence of beta-lactamase-producing bacteria are discussed.

Arch Microbiol, 1987 May, 147(4), 364 - 9
Lack of redox control of the anaerobically-induced nirB+ gene of Escherichia coli K-12; Griffiths L et al.; Operon fusion strains of Escherichia coli K-12 have been used to demonstrate that transcription of the structural gene for NADH-dependent nitrite reductase is regulated by oxygen repression and induction by its substrate, nitrite . This two-stage regulation of nirB is totally dependent upon a functional Fnr protein . Unlike the Fnr-dependent fumarate reductase operon, nirB transcription is not repressed by nitrate . These results suggest that the Fnr protein is simply a positive control protein essential for the derepression of some, but not all, anaerobically-induced operons rather than a more general redox-sensitive regulator, as suggested by the redox control hypothesis for the regulation of gene expression in facultatively anaerobic bacteria.

Am J Gastroenterol, 1987 May, 82(5), 427 - 31
Duodenal mucosal T cell subpopulation and bacterial cultures in acquired immune deficiency syndrome; Budhraja M et al.; Enteric infections, chronic diarrhea frequently with no obvious etiology, and weight loss cause major morbidity and mortality in acquired immune deficiency syndrome (AIDS) . Alterations in mucosal immunity may explain the increased incidence of enteric infections, and contamination of the upper small intestine with bacteria may be the cause of weight loss observed in these patients . To test this hypothesis we studied the mucosal T lymphocyte subset in duodenal mucosal biopsies in 14 AIDS and seven control patients . Duodenal fluid was also cultured for aerobic and anaerobic bacteria . There was a significant decrease among leu-3a T cells (helper/inducer) subset in AIDS . The proportion of mucosal T cells reacting with leu-2a (cytotoxic/suppressor) was significantly increased in AIDS patients . These patients also had a significant reversal of the normal mucosal helper/suppressor T cell ratio . There was no change in the number of leu-7 cells (cells mediate natural killer and antibody-dependent cellular cytotoxicity) as compared to controls . All patients with diarrhea and three of five patients without diarrhea had bacteria in their duodenal fluid . Mean number of organisms was 4.5 X 10(4)/ml . Cultures were negative in all control subjects . The results reveal that the abnormalities of T cell subpopulation in the blood of AIDS patients also occur in their duodenal mucosa . This immunological abnormality is associated with the bacterial colonization of upper gastrointestinal tract which may explain the diarrhea and weight loss observed in majority of our patients . The results also indicate that increased incidence of enteric infections in AIDS may be explained on the basis of altered mucosal immunity.

Jpn J Antibiot, 1987 Apr, 40(4), 727 - 34
{Clindamycin-2-phosphate in the treatment of respiratory infections and its distribution into pleural effusion}; Takamoto M et al.; We treated pneumonia due to anaerobic bacteria, Mycoplasma pneumonia, and other type of pneumonia with clindamycin-2-phosphate (CLDM-P) and studied the distribution of the drug into pleural effusion . The obtained results are summarized as follows . 1 . CLDM-P showed excellent effects in all the treated cases of pneumonia due to anaerobic bacteria and Mycoplasma pneumonia . But the success rate was 50% in cases of other type of pneumonia . We suggest that the drug must be used in due consideration of the types of causative bacteria . 2 . Five cases which had developed pleural effusions were treated with intravenous drip of CLDM-P 1,200 mg in 200 ml electrolytic solution to see the distribution into pleural effusions . The results showed that the distribution ratio was 9.0% on the average . Peak levels were 1.86-6.07 micrograms/ml and the concentration was as high as 1.28 micrograms/ml on the average 24 hours after administration.

Geburtshilfe Frauenheilkd, 1987 Apr, 47(4), 217 - 23
{Postoperative ileus}; Schmidt-Matthiesen H et al.; When the causes and pathophysiology of the various types of ileus are known there are numerous possibilities of preventing them and logical therapeutic approaches, in particular in the case of functional ileus . Careful postoperative monitoring is obligatory! With regard to stimulation of bowel function, the principle of elimination of inhibition of motility by sympathicolysis has a place alongside the well-known nonspecific measures and direct stimulation . If conservative measures fail laparotomy must be repeated as soon as possible to procure relief . In the treatment of ileus associated with peritonitis the numerous new methods of flushing the abdomen, the involvement of anaerobes in some cases, and the possibilities offered by new antibiotics should be kept in mind . The involvement or predominance of mechanical ileus factors in the clinical picture must be recognized early and surgery performed without delay . Early consultation of an abdominal surgeon is recommended.

Cryobiology, 1987 Apr, 24(2), 174 - 8
Viability of lyophilized anaerobes in two media; Staab JA et al.; Viability of 15 species of anaerobes was followed after freeze-drying and storage for 1 year . Organisms maintained in a 12% sucrose concentration in chopped meat carbohydrate broth survived longer and maintained higher viability counts than those organisms in double-strength skim milk.

Int J Oral Maxillofac Surg, 1987 Apr, 16(2), 171 - 4
Tinidazole or pivampicillin in third molar surgery; Mitchell DA et al.; There is an increasing body of evidence implicating oral anaerobic bacteria in the aetiology of post-surgical dentoalveolar infections . This information has lead to several studies demonstrating the usefulness of specific anaerobicidal drugs in the prevention and treatment of dento-alveolar infection . One such study utilised a single 2 g preoperative oral dose of tinidazole which was found to be significantly better than placebo in preventing infective sequelae after removal of impacted mandibular third molars . The present study was designed to compare a high-dose short-term broad spectrum penicillin, (pivampicillin), with the previously described regimen, using tinidazole in order to discern the existence or otherwise of any practical difference between an anaerobicidal and a broad spectrum antibiotic when local infection was considered.

Genitourin Med, 1987 Apr, 63(2), 98 - 101
Clinical and microbiological evaluation of 46 episodes of genital ulceration; Sturm AW et al.; In 44 consecutive patients 46 episodes of genital ulceration were studied . The presumptive clinical diagnosis was evaluated by extensive microbiological investigations . In 15 (33%) episodes the clinical diagnosis did not accord with the microbiological one . Chancroidal lesions were most commonly found to have other microbiological aetiology . Secondary invasion of treponemal or viral lesions by other bacterial species (mostly anaerobes or pyogenic cocci) or genital pyodermia were the cause of confusion in six of nine cases of chancroid . In the other three a ducreyilike bacterium was found . Direct Gram staining of ulcer material did not help the diagnosis of chancroid . The implications of the results of this study for clinical practice are discussed.

Obstet Gynecol, 1987 Mar, 69(3 Pt 2), 501 - 3
Avoidance of maternal morbidity in acute intrauterine infection following chorionic villus sampling; Fisk NM et al.; Serious maternal morbidity has been a feature of the few documented cases of acute intrauterine infection after chorionic villus sampling . A case is described in which infection manifested 14 days after transcervical chorion biopsy . Broad-spectrum antibiotics were begun, and ultrasound demonstrated a live fetus . After vacuum curettage was performed, repeat scan showed an empty uterus . Anaerobes isolated from the cervix both before chorionic villus sampling and during the infection were also implicated in published reports of patients developing life-threatening complications, but were not treated specifically until after morbid sequelae had occurred . Serious morbidity was avoided in this patient by aggressive management with early anaerobic cover, uterine evacuation despite the presence of a live fetus, and confirmation of complete evacuation by ultrasound.

Acta Chir Belg, 1987 Mar-Apr, 87(2), 96 - 100
{Fournier's syndrome}; Gandawidjaja L et al.; Fournier's syndrome, a necrotizing subcutaneous infection of the male genitalia, is characterized by an explosive onset and a rapid evolution . It is caused by a synergistic interaction of several aerobe and anaerobe bacteria . The immediate institution of an aggressive therapy with extensive drainage and supporting broad spectrum antibiotics gives the best results . Hyperbaric oxygen can be used as complementary therapy . Reconstructive surgery can be considered for very large tissue and skin defects.

J Antibiot (Tokyo), 1987 Mar, 40(3), 354 - 62
Quaternary heterocyclylamino beta-lactams . VI . In vitro and in vivo antibacterial properties of L-642,946 and L-652,813, a long acting cephem; Pelak BA et al.; Two newly described quaternary heterocyclylamino beta-lactams, L-642,946 and L-652,813, were shown to exhibit potent activity against a broad spectrum of aerobic and anaerobic bacteria in vitro . The activity of these agents in vitro translated well to chemotherapeutic activity in experimental bacteremias in mice . Substitution of the thiadiazine moiety of L-642,946 with a triazine moiety effected a marked change in the pharmacokinetics of the new derivative, L-652,813 . In mice given a 20 mg/kg subcutaneous dose, the peak serum concentration and the half-life of L-652,813 were about three times greater than those of L-642,946 and the area under the serum concentration/time curve was increased by about 5-fold . The pharmacokinetics of L-652,813 in mice and in rhesus monkeys more closely resembled those of ceftriaxone which carries the same triazine moiety on the C-3 side chain.

J Antibiot (Tokyo), 1987 Mar, 40(3), 301 - 8
Structure of cervinomycin, a novel xantone antibiotic active against anaerobe and mycoplasma; Nakagawa A et al.; The structures of cervinomycins A1 (1) and A2 (2), a potent anti-anaerobic and anti-mycoplasmal antibiotic were investigated by means of recent NMR techniques of O-methyl ether (3) and C,O-dimethyl ether (4) obtained by methylation of 2 with CH3I in the presence of Ag2O . The antibiotic 2 posesses a polycyclic structure involving a xanthone skeleton . The structure of 1 was confirmed to be a hydroquinone of 2 from the evidences that oxidation of 1 with Ag2O and acetylation of 1 with (CH3CO)2O in pyridine afforded quantitatively 2 and triacetylcervinomycin A1 (7), respectively.

J Clin Pathol, 1987 Mar, 40(3), 286 - 91
Wise Anaerobic Work Station: an evaluation; Sisson PR et al.; The Wise Anaerobic Work Station permitted the growth of type cultures of a range of fastidious obligate anaerobes . In the isolation of anaerobic bacteria from clinical specimens the performance equalled that of a standard anaerobic jar incubated for 48 hours, and gave results superior to those obtained when incubation of jar cultures was interrupted at 24 hours . The Wise Anaerobic Work Station was easy to use and provided comfortable working conditions; running largely on industrial nitrogen, it was more economic than anaerobic cabinets or jars using conventional gas mixtures.

Am J Pathol, 1987 Mar, 126(3), 527 - 34
Bacteria and the mucus blanket in experimental small bowel bacterial overgrowth; Sherman P et al.; Self-filling blind loops were created experimentally in jejunal segments of specific pathogen-free male Wistar rats, and the loop contents and mucosa were examined over an 8-week period for evaluation of the interaction between mucus and luminal bacteria . Corresponding jejunal segments from rats that did not undergo surgery were used as controls . Proliferation of anaerobic bacteria developed in the test animals by the first week after surgery . Despite anaerobic bacterial proliferation, no adherence by bacteria to the intestinal microvillus surface was observed by scanning or transmission electron microscopy . Rather, bacteria were present within the mucus layer overlying the intestinal mucosal surface . Immunoassay of goblet cell mucin demonstrated an increase in the proportion of mucin present in the intestinal lumen and a decrease in mucin levels in the jejunal mucosa . These results suggest that the interaction of bacteria with mucus is an important mechanism of protection of the mucosal surface in experimental small bowel bacterial overgrowth.

Biochim Biophys Acta, 1987 Feb 25, 911(3), 267 - 76
Redox properties of electron-transferring flavoprotein from Megasphaera elsdenii; Pace CP et al.; Electron-transferring flavoprotein (ETF) from the anaerobic bacterium Megasphaera elsdenii catalyzes electron transfer from NADH or D-lactate dehydrogenase to butyryl-CoA dehydrogenase . As a basis for understanding the interactions of ETF with its substrates, we report here on the redox properties of ETF alone . ETF exhibited reversible, two-electron transfer during electrochemical reduction in the presence of mediator dyes . The midpoint redox potentials of the FAD cofactor were -0.185 V at pH 5.5, -0.259 V at pH 7.1 and -0.269 +/- 0.013 V at pH 8.4, all versus the standard hydrogen electrode In the presence of the indicator dye 1-deazariboflavin, the Nernst slopes were 0.029 V and 0.026 V at pH 5.5 and pH 7.1, respectively, compared with an expected value of 0.028 V at 10 degrees C . At pH 8.4, in the presence of 2-hydroxy-1,4-naphthoquinone or phenosafranine, the Nernst slope varied from 0.021 V to 0.041 V . In the experiments at pH 8.4, equilibration was very slow in the reductive direction and a difference of as much as 30 mV was observed between reductive and oxidative midpoints . ETF exhibited no thermodynamic stabilization of the radical form of the FAD cofactor during electrochemical reduction at pH 5.5, 7.1 or 8.4 . However, up to 93% of kinetically stable, anionic radical was produced by dithionite titration at pH 8.5 . Molar absorptivities of ETF radical were 17,000 M-1 X cm-1 at 365 nm and 5100 M-1 X cm-1 at 450 nm . The four ETF preparations used here contained less than 7% 6-OH-FAD . However, two of the preparations contained significant amounts (up to 30%) of flavin which stabilized radical and reduced at potentials 0.2 V more positive than those required for reduction of the major form of ETF . This is referred to as the B form of ETF . The proportion of ETF-FAD in the B form was increased by incubation with free FAD or by a cycle of reduction and reoxidation . These treatments caused marked changes in the absorption spectrum of oxidized ETF and decreases of 20-25% in ETF units/A450.

J Antibiot (Tokyo), 1987 Feb, 40(2), 145 - 8
Abbeymycin, a new anthramycin-type antibiotic produced by a streptomycete; Hochlowski JE et al.; A new antibiotic, abbeymycin, has been isolated from Streptomyces sp . AB-999F-52 . The structure of abbeymycin was assigned on the basis of NMR, mass spectrometric and UV spectral data . Abbeymycin has weak activity against a limited number of anaerobic bacteria.

Eur J Clin Microbiol, 1987 Feb, 6(1), 74 - 5
Differentiation of obligate anaerobes by assay of pyruvate:ferredoxin oxidoreductase activity; Narikawa S et al.; In the described assay system a blue colour develops within 30 min after inoculation of obligate anaerobes, even under aerobic conditions . The simple and rapid assay may be of use in differentiating obligate anaerobes of clinical importance.

Acta Pathol Microbiol Immunol Scand {B}, 1987 Feb, 95(1), 65 - 73
Susceptibility testing of 7 antibiotics against anaerobic bacteria: comparison of 2 different media and carbon dioxide concentrations; Jansen JE et al.; Anaerobic agar (AA) and Danish Blood agar (DBA) were evaluated by a standardized agar diffusion and agar dilution test in 5% CO2 . The activity of seven antibiotics (tetracycline, clindamycin, metronidazole, rifamycin, chloramphenicol, penicillin, erythromycin) was tested against 40 anaerobic bacteria, including 3 control strains (Cl.perfringens ATCC 13124, B.fragilis ATCC 25285, B.thetaiotaomicron ATCC 29741) . 70% of the strains were resistant to erythromycin in 10% CO2, only 30% in 5% CO2 . No evident CO2-effect could be seen with the other antibiotics . Mean MIC for tetracycline was twice as great on AA than DBA . In spite of that, tablet sensitivity testing with tetracycline on AA proved to be more accurate and completely separated the resistant and susceptible strains . For penicillin, the mean MIC was one dilution step higher on AA . No major differences could be seen with the other antibiotics . AA was superior to DBA in providing growth of anaerobes . Measurement on AA was easier, and it was more precise . Except for tetracycline . MIC on control strains fell well within range set by The National Committee for Clinical Laboratory Standards (NCCLS) on AA . Acceptable correlation coefficients were recorded between agar diffusion and agar dilution . Prediction of susceptibility based on zone diameter measurements was very good on AA . Only one discrepancy that could cause change of susceptibility status occurred on AA, while there were 12 on DBA . On DBA, there was poor correlation between MIC, compared with earlier results on the same agar . The 50% inhibitory concentration (IC50) was also measured, but offered no advantage over MIC.

Eur J Clin Microbiol, 1987 Feb, 6(1), 109 - 11
Disk diffusion and disk elution tests with A-56268 and erythromycin; Barry AL et al.; Zones of inhibition around 15 micrograms A-56268 disks were essentially the same size as those around 15 micrograms erythromycin disks . If the same MIC breakpoints are to be used for defining susceptible categories for both macrolides, interpretive zone size standards for erythromycin disk tests may also be used for A-56268 disk tests . Against anaerobic bacteria, the two macrolides were only marginally effective when broth dilution tests were incubated in anaerobic jars . The aerobically incubated thioglycolate broth disk elution test indicated that both macrolides were much more effective against anaerobes . Three 15 micrograms disks eluted in 5 ml thioglycolate provided satisfactory results.

Antimicrob Agents Chemother, 1987 Feb, 31(2), 343 - 5
In vitro activity of a new macrolide, A-56268, compared with that of roxithromycin, erythromycin, and clindamycin; Barry AL et al.; A new macrolide (A-56268) was found to be approximately twice as active as erythromycin and four to eight times more active than roxithromycin . All three macrolides were similar in their potency against anaerobes . Human plasma enhanced the antistaphylococcal activity of A-56268 and erythromycin but reduced the activities of roxithromycin and clindamycin.

J Infect, 1987 Jan, 14(1), 43 - 53
Short-chain fatty acids produced by anaerobic bacteria alter the physiological responses of human neutrophils to chemotactic peptide; Eftimiadi C et al.; The effect of some short-chain fatty acids (SCFA) produced by anaerobic bacteria, namely acetic, propionic, isobutyric, butyric, isovaleric and succinic acids, on production of light and release of lysozyme by human neutrophils exposed to chemotactic peptide fMet-Leu-Phe was investigated . A short period of incubation of neutrophils with SCFA led to marked inhibition of both granulocytic chemiluminescence and degranulation (P less than 0.001) . Ultrastructural studies of neutrophils, incubated with concentrations of SCFA inhibiting the chemotactic response, chemiluminescence and release of lysozyme (30 mmol/l), effected alterations in cellular morphology with formation of protrusions of varying shape . The data reported indicate that SCFA might be regarded as important pathogenicity factors . The observed effect on neutrophils could also partially explain the ability of anaerobes to inhibit their own phagocytosis and killing as well as that of the aerobic species present in mixed infections.

Can J Surg, 1987 Jan, 30(1), 7 - 9
Postoperative gynecologic infections; Boyd ME; Postoperative gynecologic infections are caused by mixed aerobic and anaerobic bacteria that normally reside in the vagina . For the most part the infection, manifested by fever, resolves spontaneously, but occasionally serious problems result . Opinion now favours the prophylactic use of antibiotics before both abdominal and vaginal hysterectomy . Established infections are first treated with a combination of clindamycin and gentamicin.

Br J Dermatol, 1987 Jan, 116(1), 31 - 7
The infectious aetiology of tropical ulcer--a study of the role of anaerobic bacteria; Adriaans B et al.; We have cultured anaerobic bacteria from patients with tropical ulcers . Fusobacteria were isolated most frequently . Anaerobes were always present, together with aerobes or facultative anaerobes, particularly in early phase ulcers, suggesting that the combination of organisms is important in the pathogenesis of the disease . Spirochaetes were identified in material examined by light and electron microscopy, but were not cultured.

Eur J Clin Pharmacol, 1987, 32(1), 111 - 3
Pharmacokinetics of ornidazole in neonates and infants after a single intravenous infusion; Turcant A et al.; The single dose pharmacokinetics of ornidazole has been evaluated in 12 neonates or infants (aged 1 to 42 weeks) after the infusion of 20 mg/kg over 20 min . Plasma disposition was described by a two-compartment open model . The distribution phase was short (T1/2 (1) = 0.31 h) and was followed by an elimination phase (t1/2 (2) = 14.67 h) . The mean apparent volume of distribution was 0.961/kg-1 . These results did not differ from data previous by reported in adults . Total plasma clearance was between 0.4 and 1.4 ml X min-1 X kg-1 . The plasma concentration 24 h after the infusion was 7.32 mg X l-1, which was above the minimum inhibitory concentration for clinically significant anaerobic bacteria . Based on the pharmacokinetic results and residual concentrations at 24 h, a single daily infusion of ornidazole 20 mg X kg-1 appears adequate for therapy in neonates and infants.

Zh Mikrobiol Epidemiol Immunobiol, 1987 Jan, (1), 12 - 6
{Cultivation of asporogenous anaerobic microorganisms in media of various compositions}; Azizov ShA et al.; The comparative evaluation of the quality of experimental dried culture medium for the isolation and cultivation of anaerobic microorganisms, developed on the basis of locally produced ingredients without unavailable raw material suitable for human consumption, and enriched thioglycolic medium has revealed the advantage of the former and permits its recommendation for practical use in laboratories.

Ann Surg, 1987 Jan, 205(1), 77 - 81
Single-dose chemoprophylaxis in elective colorectal surgery . A comparison between doxycycline plus metronidazole and doxycycline; Bergman L et al.; In a prospective, randomized double-blind study either 400 mg of doxycycline + 1500 mg of metronidazole (D + M) or 400 mg of doxycycline (D) alone were given intravenously as a single preoperative dose to patients admitted for elective colorectal surgery . A comparison of the rate of postoperative septic complications was made . After excluding drop-out patients, 261 patients remained for evaluation . In 135 patients with D + M treatment there were four postoperative septic complications (3.0%) . In 126 patients with D treatment 20 septic complications related to the surgical procedure occurred (15.9%) . The difference is highly significant (p less than 0.005) . Most postoperative infections were superficial wound infections (14 of 24 patients), and the mean hospital stay in the two treatment groups was equal . Bacteriologic studies showed a highly significant reduction in anaerobes in cultures from perioperative intra-abdominal fluid in the D + M treatment group . The study has thus showed that the addition of metronidazole, an efficient agent against anaerobic bacteria, to an antimicrobial agent against aerobic bacteria significantly reduces postoperative septic complications in elective colorectal surgery.

Ann Chir Gynaecol Suppl, 1987, 202, 94 - 6
Single dose of ornidazole in the treatment of bacterial vaginosis; Erkkola R et al.; Bacterial vaginosis is the most common cause of excessive and foul smelling vaginal discharge . In the group of 24 women, the diagnosis was based on increased vaginal discharge, positive KOH-test, and detection of clue cells in the wet smear . In the microbiological isolation, Gardnerella vaginalis was also observed in 20 subjects and mixed anaerobic flora in all the 24 subjects . A single dose of 1.5 g of ornidazole was given . Posttreatment control was performed 7 to 28 days later . Gardnerella vaginalis was present in 2 (cure rate 90%) and anaerobes in 4 subjects (cure rate 83%) . Subjective improvement occurred in 96% of patients . Side effects, the most common of them being dizziness, after ornidazole treatment were observed by 17 (71%) of subjects.

Int J Tissue React, 1987, 9(2), 173 - 7
Non-specific vaginitis or vaginitis of undetermined aetiology; Faro S et al.; Vaginitis is a complex syndrome that is probably the most common outpatient disease seen by the gynaecologist . The specific aetiologies of vaginitis are many . One of the most common entities, however, is "non-specific vaginitis" which can be subdivided into: Gardnerella vaginitis, anaerobic vaginosis, and vaginitis of undetermined aetiology . The role of Gardnerella as a causative agent for vaginitis has been studied in depth but its specific role remains controversial . Anaerobic vaginosis can be diagnosed by noting on microscopic examination the presence of clue cells, free-floating bacteria and numerous white blood cells (WBC's) . Culturing an aliquot of the vaginal discharge reveals a high number of anaerobes . In addition, this condition responds to antibiotics effective against anaerobes, e.g., metronidazole . Vaginitis of undetermined aetiology is more complex and is characterized by a purulent vaginal discharge, a pH of 4.0-4.6, numerous WBC's, and a high concentration of bacteria . The microbiology of this vaginitis includes many facultative Gram-negative rods and Gram-positive cocci . Anaerobes may be present but do not make up a large component of the endogenous microflora . This condition does not respond to the usual antibiotic therapies employed in treating bacterial vaginitis . Since this condition appears to be primarily an inflammatory reaction, it may be responsive to topical antiinflammatory agents such as benzydamine.

Clin Ther, 1987, 10(1), 107 - 25
Comparative activity of several beta-lactam antibiotics against anaerobes determined by two methods; Zabransky RJ et al.; The susceptibility of 120 strains of several species of anaerobes to a number of second and third generation beta-lactam antibiotics was determined by the National Committee for Clinical Laboratory Standards reference agar dilution and microdilution methods . The antibiotics tested were cefoperazone, cefotaxime, cefotetan, ceftizoxime, cefoxitin, and imipenem . The MIC50s ranged from 0.125 to 16 micrograms/ml . The MIC90s were lowest with imipenem at 0.5 micrograms/ml, followed by cefoxitin at 32 micrograms/ml; they were highest with cefotetan at 128 micrograms/ml and were 64 micrograms/ml with the others . In vitro drug activity varied with the antibiotic, the organism, the method used, and the breakpoint selected . Rates of resistance varied considerably between the taxonomic groups of organisms tested and also among species within a group . Overall, reproducibility with the agar dilution method ranged from 44% to 85%; testing with ceftizoxime was the least reproducible . Microdilution results agreed within +/- 1 dilution of the agar dilution mode 79% to 95% of the time, with some variation between drugs and organisms tested . Because there were distinct differences in the activity of some drugs against certain species, no antibiotic can substitute for others in in vitro testing.

Biochem Soc Symp, 1987, 54, 45 - 65
Molecular genetic aspects of the citric acid cycle of Escherichia coli; Miles JS et al.; The genes encoding all of the citric acid cycle enzymes of Escherichia coli have been cloned and much has been learned about the structure, function and expression of these enzymes from the nucleotide sequences, the mRNA transcripts and site-directed mutagenesis of the corresponding genes . Special features of the expression of the aerobic cycle, and its anaerobic transformation into a branched pathway in a facultative anaerobe, are considered . Aspects of the structure-function relationships of succinate dehydrogenase, succinyl-CoA synthetase, fumarase and related enzymes, and the 2-oxo acid dehydrogenase complexes are reviewed.

Clin Ther, 1987, 10 Suppl A, 50 - 8
Intra-abdominal sepsis: controversies and choices in management; Nichols RL; Contamination of the peritoneal cavity may lead to generalized peritonitis or abscess formation . Both aerobic and anaerobic bacteria participate in the infectious process . The concentration and the particular mix of aerobes and anaerobes depends on the site of perforation, with the highest concentrations and greatest predominance of anaerobes in the colon . A number of factors contribute to the risk of infection, and a formula has been devised for calculating a given patient's risk for infection following intestinal perforation secondary to penetrating abdominal trauma . The goal of therapy is to reduce morbidity, mortality, and duration of hospital stay . Specific techniques used to achieve this goal are controversial . In essence, the keys to successful management of intra-abdominal sepsis are early diagnosis and surgical intervention, supplemented by systemic antibiotics that are effective against the aerobic and anaerobic components . Considerations in choosing antibiotics are efficacy, safety, and cost-effectiveness . Some second-generation and third-generation cephalosporins often offer an effective, safer, and more economical alternative to antibiotic combinations.

Clin Ther, 1987, 10 Suppl A, 2 - 11
Controversies in susceptibility testing of anaerobes; Aldridge KE; Antimicrobial susceptibility testing of anaerobic bacteria is controversial and confusing . A number of laboratory and clinical variables affect the performance and interpretation of the susceptibility data . We know that the various methods used in susceptibility testing have inherent differences that produce significantly contrasting results for certain antibiotics . We also know that some antimicrobials are affected to a greater degree than others, such as I demonstrated with ceftizoxime and cefoxitin (Table IV) . We need to study the laboratory variables that lead to differences, such as the effect of inoculum size, various test media, osmolarity, pH, incubation time and environment, and antibiotic resistant endpoints for anaerobes . When we know which variables achieve the most reliable results, we can formulate a standard method by which antimicrobial susceptibility data can be compared . Studies to establish a method that correlates well with the clinical outcome of antimicrobial therapy in patients with infections involving anaerobes is important . These studies may take a long time but are necessary to ensure that the laboratory data are useful to the physician in the management of patients with anaerobic infections . Finally, it is important to determine if time-kill kinetic studies of anaerobes and antimicrobials can be useful in predicting clinical outcome in patients with anaerobic infections . The establishment of the bactericidal activity of antimicrobials at dosing intervals may or may not prove to be more useful than traditional MIC data.

Nahrung, 1987, 31(5-6), 539 - 42
{Tests for anaerobes in patients with hemoblastosis}; Bootz TF et al.; A simplified control programme for the selective decontamination is proposed . Before the beginning of the attendance a microbial "large scale programme" is applicated in order to determine the quantitative and qualitative composition of the small intestinal and of the large intestinal flora on aerobic and anaerobic cultural conditions . During the attendance a "short-time programme" is applicated . At this on the basis of an aerobic cultural method and by the help of a direct microscopic numeration the flora is determined in its quantitative composition . At the end of an attendance the microbial "large-scale programme" is repeated.

Ann Biol Clin (Paris), 1987, 45(2), 135 - 43
{Gas-liquid chromatography in microbiological diagnosis}; Garrigues ML et al.; With gas-liquid chromatography, it is possible to detect chemical compounds which are specific of micro-organisms: either metabolic products, or structural components . This technique permits to simplify the diagnosis: it is the case for anaerobic bacteria, where the analysis of the fermentation acids produced in a 48 hours liquid culture enables to rapidly establish the diagnosis, at least as far as the genus is concerned . It may also increase the accuracy of the diagnosis by searching such or such metabolite or structural component which are specific of a species or a sub-species . Some authors have already determined automatic systems of bacterial identification; these systems are based on a computer analysis of the chromatographic profile of cellular fatty acids . Finally it is important to emphasize that liquid-gas chromatography may markedly shorten the delay of identification by allowing, in some cases, a direct diagnosis in pathological samples.

J Basic Microbiol, 1987, 27(4), 197 - 201
{Supplementary methods for the determination of the Gram reaction of anaerobic pathogens}; Hohne C et al.; Anaerobic microorganisms (364 gram-negatives and 154 gram-positives) were investigated with respect to their behaviour against aqueous solutions of potassium hydroxide as well as their sensitivity to polymyxin and vancomycin by means of the disk diffusion test . Whereas the gram-negative anaerobes showed a good correlation (97.5%) with a positive KOH test, only 88.3% of the gram-positive microorganisms exhibited a negative KOH reaction . Therefore, in cases of ambiguous gram-negative staining results, the KOH test alone cannot give sufficient informations about the exact gram reaction . It was shown, however, that together with the determination of resistance to polymyxin and vancomycin, this uncertainty remains only for microorganisms showing a positive KOH reaction, polymyxin resistance, and vancomycin sensitivity . Therefore, in combination with the polymyxin and vancomycin disk diffusion test, the KOH test is recommended as an additional means to determine the gram reaction of anaerobes.

Biochem Biophys Res Commun, 1986 Dec 30, 141(3), 1032 - 41
Low-spin sulfite reductases: a new homologous group of non-heme iron-siroheme proteins in anaerobic bacteria; Moura I et al.; Two new low molecular weight proteins with sulfite reductase activity, isolated from Methanosarcina barkeri (DSM 800) and Desulfuromonas acetoxidans (strain 5071), were studied by EPR and optical spectroscopic techniques . Both proteins have visible spectra similar to that of the low-spin sulfite reductase of Desulfovibrio vulgaris strain Hildenborough and no band at 715 nm, characteristic of high-spin Fe3+ complexes in isobacteriochlorins is observed . EPR shows that as isolated the siroheme is in a low-spin ferric state (S = 1/2) with g-values at 2.40, 2.30 and 1.88 for the Methanosarcina barkeri enzyme and g-values at 2.44, 2.33 and 1.81 for the Desulfuromonas acetoxidans enzyme . Chemical analysis shows that both proteins contain one siroheme and one {Fe4S4} center per polypeptidic chain . These results suggest that the low molecular weight, low-spin non-heme iron siroheme proteins represent a new homologous class of sulfite reductases common to anaerobic microorganisms.

Dtsch Med Wochenschr, 1986 Dec 5, 111(49), 1874 - 80
{Septicemia causative organisms 1983-1985 . The results of a multicenter study}; Rosenthal EJ; 8,999 septicaemia pathogens were isolated from 8,500 patients during a two-year period by eleven institutes in West Germany, two institutes in West Berlin und two institutes in Austria . 54% of the patients were male . Septicaemias occurred very often in neonates, rarely in the second decade of life, and then with rising incidence up to a maximum in the seventh decade . Gram-negative rods were isolated in 49% of the samples, gram-positive cocci in 45%, anaerobic bacteria in 2.5% and blastomycetes in 1.9% . The spectrum of pathogens in children was markedly different from that in adults . Slight differences depended on the type of hospital and the specialised institution or the ward submitting the samples . The minimum inhibitory concentration was determined to assess the susceptibility of the bacteria to antibiotics.

J Anim Sci, 1986 Dec, 63(6), 1949 - 59
Sulfur influences on rumen microorganisms in vitro and in sheep and calves; Slyter LL et al.; When continuously cultured ruminal microbes were given orchardgrass hay and sufficient sulfuric acid or hydrochloric acid to maintain a pH of 5.5, fermentation and numbers of protozoa were reduced compared with cultures whose pH was controlled with phosphoric acid . Likewise, when sulfur-deficient, purified diets were supplied to cultures, less methane (mmol X liter-1 X d-1), 3.2 vs 32.6, was produced and fewer cellulolytic bacteria (log10/ml), 5.8 vs 7.2 were present than when cultures were given the same diet supplemented with .3% elemental sulfur . The rumen of sheep fed the .04% sulfur diet had reduced digesta weights (1.69 vs 3.2 kg) compared with sheep fed the diet with .34% sulfur at the same intake . There also was reduced methanogenesis 12.3 vs 25.8 mmol X liter-1 X d-1) and reduced numbers of cellulolytic bacteria (7.4 vs 8.4 log10/ml) in sulfur-deficient sheep in comparison to sulfur-supplemented sheep . In growing calves, the same types of bacteria predominated in the rumen, but more facultative anaerobic bacteria were isolated from calves fed .04% sulfur than from calves fed diets with .34 to 1.72% sulfur . None of the dietary levels of sulfur appeared toxic . Regardless of treatment, volatile fatty acids were more predominant than lactic acid as end-products of fermentation of ruminal microbes in fermenters, sheep and calves . The greater methanogenesis and the greater cellulolytic bacterial numbers of sulfur-supplemented sheep compared with sulfur-deficient in vitro cultures, is interpreted to be the result of recycling of sulfur to the rumen in sheep where it is efficiently scavengered by ruminal bacteria.

Br J Urol, 1986 Dec, 58(6), 715 - 20
Leucocytes in the ejaculate from fertile and infertile men; el-Demiry MI et al.; The presence of leucocytes and their subpopulations was studied in the ejaculate from 69 men with an infertile marriage and 12 fertile men . Monoclonal antibodies specific for human leucocytes were used in an immunoperoxidase technique . In addition to the standard sperm analysis, each specimen was also tested for sperm antibodies, aerobic and anaerobic microorganisms, Ureaplasma urealyticum and Chlamydia trachomatis . Leucocytes were found in large numbers in the fertile men compared with the patients . Lymphocytes were found in 20% of the patients . Micro-organisms were cultured from a similar proportion of both groups . We found no correlation between leucocyte counts, sperm density and motility, sperm antibodies and growth of micro-organisms . Our results cast doubt on the conventional criteria of subclinical genital tract infection, namely positive culture and excess leucocyte counts.

Gastroenterology, 1986 Dec, 91(6), 1495 - 502
Production of secretory immunoglobulin A in rat self-filling blind loops . Local secretory immunoglobulin A immune response to luminal bacterial flora; Lichtman S et al.; The immunoglobulin A (IgA) response to small intestinal bacteria was studied in rats with self-filling blind loops (SFBLs), surgically constructed in continuity with the intestine or at the end of a Roux-en-Y loop (RY-SFBL) so as to avoid filling with chyme . Total bile salt in the RY-SFBL lumen was much lower (4.35 +/- 0.8 mumol) than in the SFBL lumen (116 +/- 15 mumol), but other parameters, such as the number of anaerobic bacteria and disaccharidase activities were similar . Within 1 wk of establishing the blind loops, they had accumulated at least 14 times as much IgA as found in the normal jejunum . Luminal IgA per milligram mucosal protein was almost as high in the RY-SFBL as in the SFBL, indicating that a significant proportion of the IgA must be nonbiliary and probably mucosal in origin . Oral treatment with lincomycin significantly reduced luminal IgA accumulation in the RY-SFBL . Column chromatography and enzyme-linked immunosorbent assay (ELISA), which employed antirat secretory component antibody, established that the majority of the luminal IgA was nonmonomeric and complexed with secretory component . Centrifugation of luminal contents to separate soluble and particulate bound IgA showed that the RY-SFBL contained a higher proportion of precipitable IgA than either the SFBL or lincomycin-treated RY-SFBL . Immunoglobulin A eluted from the precipitates by KSCN was bound to a greater extent by bacterial sonicates than IgA in the supernatant . For either precipitate or supernatant IgA, the greatest binding was observed when the IgA was obtained from the RY-SFBL . These observations indicate that rat intestinal mucosa rapidly responds to bacterial overgrowth by secreting secretory immunoglobulin A (sIgA) with specificity for luminal bacterial antigens . As the sIgA present within the SFBL is to a certain extent derived from bile, the lower proportion of SFBL sIgA bound by bacterial antigens than of RY-SFBL sIgA suggests that biliary sIgA is less specific for local antigens than the sIgA that is secreted by the local mucosa.

Rhinology, 1986 Dec, 24(4), 257 - 64
Microbial flora of nose and paranasal sinuses in chronic maxillary sinusitis; Almadori G et al.; Nasal secretions, maxillary sinus aspirates and specimens of the maxillary sinus mucosa were collected in 44 patients aged between 25 and 60 affected by mono- or bilateral chronic maxillary sinusitis, in order to establish the best sampling technique for microbiological purposes, the most frequently involved bacteria and the physiopathological mechanism underlying chronic maxillary disease . The sinusal mucosa resulted to be the most reliable sample as it reduces contamination and microbial variability . Anaerobic bacteria were isolated in nasal swab (15.6%), in maxillary sinus aspirates (30.4%) and in maxillary sinus mucosa (36.4%) of maxillary sinusitis patients . In controls anaerobic bacteria were isolated only in one nasal swab (2.3%), while they could not be isolated in maxillary sinus aspirates and in maxillary sinus mucosa . The presence of anaerobic bacteria in chronic maxillary sinusitis patients and their absence in controls seem to confirm that anaerobic microorganisms represent the main pathogenetic agents of chronic maxillary sinusitis . The possible physiopathological mechanisms underlying chronic maxillary sinus disease are finally discussed.

Chest, 1986 Dec, 90(6), 810 - 4
Community-acquired pneumonia caused by mixed aerobic bacteria; Brown RB et al.; Mixed bacterial pneumonia caused by organisms other than anaerobes has been infrequently reported . We describe six cases and review the literature . Two patients had co-infection with S pneumoniae and L pneumophila . Two were infected with S pneumoniae and K pneumoniae and the others simultaneously harbored M tuberculosis and N asteroides . The first two sets of patients had bacteria isolated from usually sterile sites (blood and lung), while the latter harbored repeatedly isolated organisms not usually felt to be part of the normal respiratory flora . Mixed infection may help explain the substantial mortality still seen from pneumonia . This is especially true if Legionella, mycobacteria, or Nocardia species are encountered where routine smears and cultures may not aid in the diagnosis . Poor clinical response to specific antibacterial therapy in pneumonia should trigger further investigation for other potential pathogens.

J Clin Microbiol, 1986 Nov, 24(5), 886 - 7
Clinical comparison of lysis-centrifugation and radiometric resin systems for blood culture; Brannon P et al.; The Isolator 10 lysis-centrifugation blood culture system (E . I . du Pont de Nemours & Co., Inc., Wilmington, Del.) and the BACTEC 16B-17D radiometric resin system (Johnston Laboratories, Inc., Towson, Md.) both remove antimicrobial agents from the blood for culture . We compared these two systems for recovery of aerobic bacteria, facultatively anaerobic bacteria, and yeasts . A total of 5,000 blood cultures yielded 467 clinically significant isolates . Both systems recovered 350 (75%) organisms, 56 (12%) were detected by Isolator only, and 61 (13%) were detected by BACTEC resin bottles only . No group of organisms was isolated significantly more often from either system.

Urologe A, 1986 Nov, 25(6), 361 - 3
{Gas gangrene in urologic diseases . An example based on 3 case reports}; Dahm FJ et al.; Gas gangrene is a rare infection of grave consequences . It is caused by obligatory anaerobic bacteria . Its appearance in urology is extremely rare . The infection can be acquired either from the outside or from enteral invasion of saprophytes, which are common in body cavities . Very often resistance-weak patients are attacked . In acute cases with typical signs of sepsis in addition to local signs of infection, a fatal outcome cannot be prevented in all cases despite adequate early therapy . Search for bacteria is mostly in vain . The 3 cases demonstrate that absolute asepsis and hygienic rules in simple manipulations (e.g . catheterizing as well as in major urologic operations are absolutely necessary . Traumatic lesions must be reduced to a minimum . Therapy must be started immediately.

Nucleic Acids Res, 1986 Oct 24, 14(20), 7939 - 51
Cloning the DdeI restriction-modification system using a two-step method; Howard KA et al.; DdeI, a Type II restriction-modification system from the gram-negative anaerobic bacterium Desulfovibrio desulfuricans, recognizes the sequence CTNAG . The system has been cloned into E . coli in two steps . First the methylase gene was cloned into pBR322 and a derivative expressing higher levels was constructed . Then the endonuclease gene was located by Southern blot analyses; BamHI fragments large enough to contain the gene were cloned into pACYC184, introduced into a host containing the methylase gene, and screened for endonuclease activity . Both genes are stably maintained in E . coli on separate but compatible plasmids . The DdeI methylase is shown to be a cytosine methylase . DdeI methylase clones decrease in viability as methylation activity increases in E . coli RR1 (our original cloning strain) . Therefore the DdeI system has been cloned and maintained in ER1467, a new E . coli cloning strain engineered to accept cytosine methylases . Finally, it has been demonstrated that a very high level of methylation was necessary in the DdeI system for successful introduction of the active endonuclease gene into E . coli.

Jpn J Antibiot, 1986 Oct, 39(10), 2675 - 84
{Clinical evaluation of ciprofloxacin on biliary tract infection following oral administration}; Nakamura T et al.; A newly synthesized antibiotic of quinoline carboxylic acid group, ciprofloxacin (BAY o 9867, CPFX) for oral administration, has a broad spectrum and high antibacterial activity against various bacterial species including aerobic and anaerobic bacteria such as P . aeruginosa and B . fragilis . The CPFX was administered orally in a dose of 200 mg 3 times daily for 5 to 8 days (6.3 +/- 1.0 days) to 12 patients with biliary tract infection consisting of 2 males and 10 females . Two of them were outpatients and 10 were hospitalized . Ages ranged from 27 to 72 years (mean 51.8 +/- 14.8 years), weights from 48.5 to 73.5 kg (mean 60.5 +/- 7.7 kg) . All cases were complicated with cholecystolithiasis, with 4 acute and 8 subacute cases . Organisms isolated before the initiation of the CPFX treatment included 3 strains of E . coli from ERCP bile of 3 cases . Infected bacteria were eradicated in 3 cases but results were unknown in the other 9 cases . Clinical responses were excellent in 2 cases, good in 8 cases, fair in 1 case and poor in 1 case . No adverse effect was recognized . Therefore, CPFX appears to be a very useful drug when used for chemotherapy of biliary tract infectious diseases.

J Antibiot (Tokyo), 1986 Oct, 39(10), 1413 - 8
Clostomicins, new antibiotics produced by Micromonospora echinospora subsp . armeniaca subsp . nov . II . Taxonomic study of the producing microorganism; Takahashi Y et al.; Taxonomic properties of actinomycete strain KMR-593, a soil isolate, which produces new anti-anaerobe antibiotics, clostomicins, were investigated . The strain was identified as a new subspecies of the genus Micromonospora and designated Micromonospora echinospora subsp . armeniaca subsp . nov.

J Antibiot (Tokyo), 1986 Oct, 39(10), 1407 - 12
Clostomicins, new antibiotics produced by Micromonospora echinospora subsp . armeniaca subsp . nov . I . Production, isolation, and physico-chemical and biological properties; Omura S et al.; A soil isolate named as Micromonospora echinospora subsp . armeniaca subsp . nov . KMR-593 was found to produce at least five related antibiotics, clostomicins, active against Gram-positive bacteria including anaerobes . From the physico-chemical properties, one of these components was identified with lipiarmycin and others were found to be new antibiotics . Each component includes two chlorine atoms and the molecular weights of A and B2, C, and D are 1,058, 1,042 and 1,056, respectively . The structural differences were characterized by NMR analyses.

Appl Environ Microbiol, 1986 Oct, 52(4), 971 - 3
Quantitative method for measurement of aerotolerance of bacteria and its application to oral indigenous anaerobes; Kikuchi HE et al.; An index which expressed the aerobic to anaerobic potential was made for bacteria with intermediate tolerance for oxygen . One method used for this analysis was measurement of the relative bacterial growth ratio . The other method was based on the pattern of the absorbancy versus depth plot . The index was applied to oral indigenous anaerobes.

Appl Environ Microbiol, 1986 Oct, 52(4), 861 - 5
Complete reductive dechlorination and mineralization of pentachlorophenol by anaerobic microorganisms; Mikesell MD et al.; Anaerobically digested municipal sewage sludge which had been acclimated to monochlorophenol degradation for more than 2 years was shown to degrade pentachlorophenol (PCP) . Di-, tri-, and tetrachlorophenols accumulated when PCP was added to the individual acclimated sludges . When the 2-chlorophenol- (2-CP), 3-CP-, and 4-CP-acclimated sludges were mixed in equal volumes, PCP was completely dechlorinated . The same results were obtained in sludge acclimated to the three monochlorophenol isomers simultaneously . With repeated PCP additions, 3,4,5,-trichlorophenol, 3,5-dichlorophenol, and 3-CP accumulated in less than stoichiometric amounts . All chlorinated compounds disappeared after PCP additions were stopped . All chlorinated compounds disappeared after PCP additions were stopped . Incubations with {14C}PCP resulted in 66% of the added 14C being mineralized to 14CO2 and 14CH4 . Technical-grade PCP was found to be degraded initially at a rate very similar to that of reagent-grade PCP, but after repeated additions, the technical PCP was degraded more slowly . Pentabromophenol was also rapidly degraded by the mixture of acclimated sludges . These results clearly show the complete reductive dechlorination of PCP by the combined activities of three chlorophenol-degrading populations.

Acta Pathol Microbiol Immunol Scand {B}, 1986 Oct, 94(5), 319 - 23
Effect of culture medium and carbon dioxide concentration on growth of anaerobic bacteria and medium pH; Jansen JE et al.; Two Danish agars, Danish Blood Agar (D.B.A.) and Anaerobic Agar (A.A.), were evaluated for their ability to support growth of 47 clinically isolated anaerobic strains in 5 different CO2-concentrations ranging from 0-10% CO2 . CO2 and the use of an enriched medium (A.A.) are essential for satisfactory recovery of anaerobes . No gain could be seen when raising the CO2-concentration above 5% . The surface pH of the agars was measured both on non-inoculated and inoculated plates at room temperature and anaerobic incubation in the 5 different CO2-concentrations at 37 degrees C . Temperature change from room temperature to 37 degrees C resulted in a pH decrease of 0.1 units . There was a CO2-mediated decrease in pH (approximately 0.05 units/pr . CO2%) on non-inoculated media . On inoculated plates there was a minor additional fall in pH, which increased with time of incubation, but first became significant when the plates were incubated for more than 24 h . The use of 5% CO2 and A.A . is recommended for antimicrobial susceptibility studies on solid media.

Schweiz Med Wochenschr, 1986 Sep 20, 116(38), 1309 - 16
{Diagnosis and therapy of lung abscess}; Mordasini C et al.; 10 patients with primary lung abscess have been treated for 2 years . The patients were predominantly middle-aged men with predisposing factors for aspiration such as, essentially, alcoholism . All patients were in a fairly good general condition . The most frequent symptom was purulent foul smelling sputum . Most abscesses were found in the dorsal segments of both lower lobes and of the right upper lobe . Bacteriological examination of abscess punctate frequently revealed anaerobic bacteria . The primary treatment in all cases was conservative, including postural drainage and longterm therapy with high dose penicillin or amoxicillin . In 9 cases this led to complete clinical and radiological recovery; only 1 patient had to be operated on because of failure of conservative therapy . Aspiration of anaerobic bacteria from the oropharynx is of prime importance in the genesis of primary lung abscess . Therapy is conservative, with penicillin as the drug of choice.

Jpn J Antibiot, 1986 Sep, 39(9), 2367 - 73
{Bacteriological and clinical studies of premature rupture of the membranes}; Chimura T et al.; Cases of premature rupture of the membranes (PROM) were subjected to bacteriological examination of lower genital organs and their clinical courses were analyzed . The results obtained were summarized below . From lower genital organs of cases examined at the 24th-36th week of pregnancy, Gram-positive or Gram-negative aerobes were detected at a high rate in both the group without PROM (-) and the group with PROM (+) . From patients in the group with PROM + chorioamnionitis (CAM) anaerobes as well as aerobes were detected at especially high rates . Many patients with PROM (+CAM) were administered with penicillin-antibiotics orally or parenterally . Clinical analysis showed effectiveness of these antibiotics which were especially effective when administered intravenously . The oral administration produced inferior results to the injection judging from clinical results . Patients with PROM and infection during the puerperal period were examined . They were found to include 15 cases of intrauterine infection and 6 cases of puerperal fever . Patients who started showing infectious symptoms at a later time than 8 hours after the onset of PROM tended to have a higher frequencies of infections . The rate of occurrence of cases requiring cesarean section was higher in this group than in the group where infectious symptoms started within 8 hours after PROM.

Arzneimittelforschung, 1986 Sep, 36(9), 1417 - 20
Transfer of ciprofloxacin to bile and determination of biliary metabolites in humans; Tanimura H et al.; 1-Cyclopropyl-6-fluoro-1,4-dihydro-4-oxo-7-piperazin-1-ylquinol ine-3-carboxylic acid (ciprofloxacin, Bay o 9867; designated tradename: Ciprobay) is a new synthetic pyridone-carboxylic acid antimicrobial agent for oral use which has high activity against gram-positive and gram-negative bacteria and anaerobes . In 8 patients with T-tube drainage, the biliary excretion of ciprofloxacin and its metabolites including the glucuronide were determined by bioassay and HPLC . After single oral administration of ciprofloxacin 400 mg in 5 patients, the biliary excretion of the drug was investigated for 12 h . The peak biliary concentration of ciprofloxacin was 15.0 +/- 6.3 micrograms/ml by bioassay and 11.0 +/- 4.0 micrograms/ml by HPLC . The biliary concentration of the drug was 10 times as high as its serum concentration, indicating a good biliary excretion . The proportion of ciprofloxacin glucuronide in the biliary excretion, calculated from the difference between the concentration before beta-glucuronidase hydrolysis and that after the hydrolysis, was 30% . In 3 patients, biliary metabolites of ciprofloxacin were investigated . Main metabolites were the sulfone compound (Bay s 9435) and the oxo compound (Bay q 3542) and, in addition, a minor metabolite was detected.

Biochem Cell Biol, 1986 Sep, 64(9), 898 - 905
Activation of phosphoenolpyruvate carboxykinase isolated from Veillonella parvula; Chau HS et al.; Phosphoenolpyruvate carboxykinase (PEPCK, EC 4.1.1.49) has been purified 940-fold from Veillonella parvula using protamine sulphate treatment, ammonium sulphate precipitation, and column chromatography . The purified enzyme was substantially free of contaminating enzymes or proteins . Maximum activity in the direction of oxaloacetate (OAA) decarboxylation was exhibited at pH 9.0 . At this pH, the V . parvula enzyme catalysed phosphoenolpyruvate formation in the presence of Mn2+ ions . In the presence of varying concentrations of OAA and ATP, the PEPCK from V . parvula exhibited hyperbolic kinetics with KmS of 0.16 and 0.46 mM, respectively . PEPCK from the anaerobe was not inhibited by NADH, succinate, glutamate, D-glucose-6-phosphate, acetyl phosphate, D-fructose, 1,6-bisphosphate, pyruvate, ribose 5-phosphate, and aspartate . However, acetyl CoA, glyceraldehyde 3-phosphate, 3-phospho-D-glycerate, CTP, and GTP activated the enzyme . The activation of acetyl CoA was uncompetitive and noncooperative.

Arzneimittelforschung, 1986 Sep, 36(9), 1297 - 300
Synthesis and antimicrobial activity of 7 alpha-methoxypyrimidinyl-ureidocephalosporins; Maier R et al.; The synthesis of a series of 7 alpha-methoxy-7-{(R)-2-{3-{5-pyrimidinyl}ureido}-2-(4-hydroxyphenyl) acetamido}-3-cephem-4-carboxylates 2 is described . 7-{(R)-2-{3-{2-(p-Aminosulfonyl)-anilino-4-hydroxy-5-pyrimidinyl}ureido- 2-(4-hydroxyphenyl)acetamido}-7 alpha-methoxy-3-{(1-methyl-1H-tetrazol-5 -yl)thio}methyl-3-cephem-4-carboxylic acid, sodium salt (2k, UG-FA 132), has exhibited a broad range of antimicrobial activity . UG-FA 132 is highly active against Gram-positive and Gram-negative organisms, including Pseudomonas and lactamase producers, and shows potent activity against anaerobes . The high efficacy of UG-FA 132 was confirmed by in vivo experiments in mice.

Rev Infect Dis, 1986 Sep-Oct, 8(5), 809 - 13
Rationale for identification and susceptibility testing of anaerobic bacteria; Swenson RM; Anaerobic bacteria are involved in a wide variety of human infections . In recent years there have been major refinements in technical materials used for transporting specimens, growing and identifying anaerobic bacteria and performing antimicrobial susceptibility tests . Because of the major importance of anaerobic bacteria and their changing susceptibility patterns, it has become increasingly important to identify these organisms and, in certain situations, to determine susceptibilities . The commercial availability of prereduced, anaerobically sterilized systems for identification has been helpful . However, the recent development of rapid identification systems based on tests for preformed enzymes has been a major advance . Finally, the commercial availability of broth microdilution susceptibility systems makes routine testing feasible . Guidelines for using these procedures are presented.

J Clin Periodontol, 1986 Sep, 13(8), 783 - 8
Clinical and microbiological effects of sustained release chlorhexidine in periodontal pockets; Stabholz A et al.; Previous studies have shown that a 3-day exposure of the pocket flora to the sustained release of chlorhexidine significantly reduced the relative numbers of spirochetes and motile rods in periodontal pockets to negligible amounts . By 14 days post-treatment, their numbers had returned to pre-treatment levels . The present study extended the exposure time of the pocket flora to the sustained release of chlorhexidine in an attempt to prolong the suppression of the microbial flora for a clinically significant period of time . Clinical parameters were also studied . Sustained release devices (SRD) were inserted into 13 pockets from 8 patients . Pocket depth ranged between 5 and 8 mm . The SRD's were replaced every 3 days to give a total exposure of 9 days . Plaque index (PlI), bleeding on probing and pocket depth were measured, and bacterial samples taken for dark field microscopy and anaerobic culture . There was a marked decrease in the relative proportions of spirochetes and motile rods and the total anaerobic count post-treatment . Pocket depth was reduced in all 13 pockets . These results indicate that a prolonged exposure to chlorhexidine suppresses the pocket flora to negligible amounts and reduces pocket depth for up to 11 weeks post-treatment.

Am J Orthod Dentofacial Orthop, 1986 Sep, 90(3), 181 - 6
Toothbrushing and transient bacteremia in patients undergoing orthodontic treatment; Chung A et al.; A study was made to determine the extent of bacteremia experienced by patients undergoing orthodontic treatment with fixed appliances during periods of routine oral hygiene--namely, brushing the teeth . Sixteen orthodontic patients made up the population--11 who practiced good oral hygiene and five who demonstrated poor oral hygiene . Blood was drawn aseptically from the median cubital vein of the subjects before and 15 minutes after brushing the teeth . An aliquot of each blood specimen was added to separate blood culture bottles and incubated at 37 degrees C for a period of up to 5 days . Blood was also used to determine the immune status of the subjects . Anaerobic bacteria were recovered from the blood of nine of the 16 patients studied; aerobic bacteria were not recovered . A negative blood culture before brushing and positive blood culture after brushing were expected but did not occur . Some subjects showed bacteremia before brushing and a negative blood culture after brushing . Others showed bacteremia before and after brushing . The unexpected results could be attributed to the patients eating and/or brushing before starting the test . The study showed the capacity of specific anaerobic bacteria to remain in the bloodstream for a 15-minute period . It also demonstrated a presence of bacteria in the bloodstream before the test began.

Gastroenterology, 1986 Sep, 91(3), 673 - 82
Translocation of indigenous bacteria from the gastrointestinal tract of mice after oral ricinoleic acid treatment; Morehouse JL et al.; A single dose of ricinoleic acid, the active component of castor oil, administered intragastrically to specific pathogen-free mice produced significant alterations in the proximal small intestinal mucosa . Two hours after drug administration, the duodenal villi were markedly shortened with massive exfoliation of columnar and goblet cells . This disruption of the mucosal barrier resulted in continuity between the intestinal lumen and the lamina propria of the villi . Because of the loss of the mucosal barrier, bacteria of the indigenous gastrointestinal flora translocated from the gastrointestinal lumen to the mesenteric lymph nodes, spleen, and liver . The peak incidence of bacterial translocation occurred 4 days after the ricinoleic acid treatment . Strictly anaerobic bacteria, which normally colonize the gastrointestinal tract at greater levels than aerobic or facultatively anaerobic bacteria, were translocated at a greater incidence to the mesenteric lymph nodes than were the other indigenous bacteria . The mucosa began regenerating within 4 h after the ricinoleic acid treatment and viable translocated bacteria were no longer cultured from the mesenteric lymph nodes by 7 days after treatment.

J Parasitol, 1986 Aug, 72(4), 545 - 9
The bacterial flora of the intestine of Ascaris suum and 5-hydroxytryptamine production; Hsu SC et al.; Representative facultative anaerobes of the bacterial flora from the intestine of female Ascaris suum were isolated and identified . The number of bacteria in the intestine was approximately 4 X 10(9) per g wet weight of intestine . Seventeen of 19 of the isolated colonies were found to secrete 5-hydroxytryptamine in culture . Holding A . suum in an antibiotic-containing medium did not affect the levels of 5-hydroxytryptamine in the worm, which were 231 +/- 14 ng/g in antibiotic-media as compared to 250 +/- 16 ng/g in control media . This implied that the bacteria may not be contributing to the level of 5-hydroxytryptamine in the tissues of A . suum.

Infusionsther Klin Ernahr, 1986 Aug, 13(4), 186 - 90
{Ammonia and glutamine metabolism of the intestine . The effect of lactulose and neomycin}; Soeters PB et al.; The present work is directed to distinguish between ammonia production by the mucosa and by the intestinal flora, as well as to evaluate the influence of neomycin and lactulose . In vitro studies using rat intestine show that mucosa cells produce ammonia alanine and glutamic acid when incubated with glutamine, whose process can be impaired by neomycin or lactulose . Since the release of the above solutes is virtually the same in germ-free rats, the influence of the bacterial flora might be negligible under the experimental conditions used . Elimination of the aerobic microorganisms results in a minute decrease of ammonia concentration in portal blood in contrast to elimination of the anaerobic flora, which leads to an excessive reduction of ammonia formation . In germ-free rats colonisation with anaerobic microorganisms results in an increment in portal ammonia concentration, whose value, however, is still below levels observed in normal animals . Colonisation with aerobic bacteria has no effect on portal ammonia concentration . Neomycin and lactulose affect ammonia production in the gut by interfering with glutamine uptake in the mucosa cell, thus the influence upon ammonia formation apparently can not be exclusively explained by alterations of the intestinal flora . Possible reasons for the considerable increase in arterial glutamine levels in normal rats are discussed.

Am J Vet Res, 1986 Aug, 47(8), 1726 - 9
Pharmacokinetics of metronidazole given to horses by intravenous and oral routes; Sweeney RW et al.; Serum and peritoneal fluid concentrations of metronidazole were determined in 6 healthy adult horses given the drug (25 mg/kg) by IV or oral routes . The disposition of metronidazole in horses given the drug by the IV route conformed to a 2-compartment model with a distribution half-life of 0.16 hours, an elimination half-life of 2.9 hours, and a body clearance of 0.40 +/- 0.05 L/kg/hr . The oral absorption half-life was 0.40 hours, and the bioavailability, 85.0 +/- 18.6% . Peritoneal fluid concentrations were approximately equal to serum concentrations at all times, regardless of the route of administration . On the basis of reported minimal inhibitory concentrations for anaerobic bacteria, a dosage of 15 to 25 mg/kg given orally 4 times daily was recommended.

Br J Obstet Gynaecol, 1986 Aug, 93(8), 804 - 10
Spontaneous early preterm labour associated with abnormal genital bacterial colonization; Lamont RF et al.; The association between infection and preterm labour was studied in 72 women in spontaneous preterm labour between 26 and 34 weeks gestation and in 26 control subjects having an elective caesarean section at the same gestational age . The genital microbial flora of each group was studied comprehensively and included mycoplasmas, chlamydiae, ureaplasmas and anaerobes . Subsequent neonatal infection and chorioamnionitis was also studied . Abnormal bacterial colonization, the presence of ureaplasmas, heavy growth of mycoplasmas and chorioamnionitis were all found significantly more often in the study group . This supports the premise that a significant proportion of idiopathic preterm labour is associated with infection and this may permit better prediction and prevention of preterm birth . The continued use of tocolytics should depend upon the identification of the presence or absence of infection . Infection appeared to be the result rather than the cause of ruptured membranes . A recommendation with respect to the classification of abnormal or normal bacterial colonization between 26 and 34 weeks is suggested on the basis of strict criteria.

Obstet Gynecol, 1986 Aug, 68(2), 220 - 5
Significance of endometrial cultures performed at cesarean section; Awadalla SG et al.; To determine the bacterial pathogenesis of postcesarean endomyometritis, swab endometrial cultures of the lower uterine segment were taken intraoperatively in 160 cases . Both aerobic and anaerobic cultures were obtained . Of all patients, 16.8% developed endomyometritis . There was a statistically significant relationship between positive cultures and the development of endomyometritis . The organisms isolated were those commonly found in other types of pelvic infection: pathogenic aerobes and anaerobes as well as commensals . An average of 1.3 organisms were recovered per patient with positive cultures . An analysis is provided for findings depending on the status of membranes and the influence of labor . The following risk factors were identified for the development of endomyometritis: primary cesarean section, labor, ruptured membranes, and postoperative hematocrit . Implications of these findings and a review of similar studies is provided.

Clin Rheum Dis, 1986 Aug, 12(2), 403 - 21
Animal models of infectious arthritis; Mahowald ML; The results from animal studies of bacterial joint infection have demonstrated pathogenic changes in synovium, cartilage, and bone which lead to joint destruction . Mechanisms responsible for the changes in these articular components remain to be more completely defined in order to develop methods to prevent articular destruction . Eradication of the active infectious process with early institution of antibiotics and adequate drainage is required but is not sufficient to prevent chronic destructive processes initiated by the acute bacterial infection . Biochemical effects of changes in the anabolic and catabolic functions of the cells in bone, cartilage, and synovium and the control mechanisms for these functions undoubtedly hold the key to prevention of destruction in infectious arthritis . Much less is understood about the pathogenic changes and mechanisms in infections caused by anaerobic bacteria, mycobacteria, fungi or viruses . Application of advances in immunological, morphological and biochemical techniques to animal models of infectious arthritis provides the opportunity to increase understanding of pathogenic mechanisms and to develop innovative methods of treatment.

Jpn J Antibiot, 1986 Aug, 39(8), 2214 - 8
{Fundamental and clinical evaluation of ceftazidime in perinatal studies}; Sengoku K et al.; In a chemotherapy of perinatal infections, the safety of mothers and their neonates and the transfer of a drug to amniotic fluid and fetus as well as its bacteriological efficacy are some of the important factors . In the present study, the authors have carried out a pharmacokinetic evaluation on the transfer of ceftazidime (CAZ), a new cephalosporin, to amniotic fluid and umbilical cord serum, and also a clinical study on its efficacy and safety in 3 cases of perinatal infections . Transfer ratios of CAZ to umbilical serum and to amniotic fluid were 25.3-46.5% and 0.6-17.5% (of maternal serum), respectively, after 1 g of CAZ was administered by bolus intravenous injection, and 24.3-85.8% and 1.6-17.5% (of maternal serum), respectively, after 2 g of CAZ was administered by bolus intravenous injection . These levels were high enough to expect that CAZ is an effective antibiotic both for treatment and prophylaxis of intrauterine fetal infections . Out of the 3 cases treated with CAZ, clinical efficacy was good in 2 cases which did not respond to other antibiotics . CAZ was considered to be clinically effective, although the number of cases treated was small . No abnormalities were observed at all either in subjective symptoms or objective findings in laboratory findings such as hepatic and renal functions of mothers, or neonates . This confirmed the high safety of CAZ . As earlier reports indicate, CAZ has a broad-spectrum of antibacterial activity against various bacteria including Gram-negative organisms and anaerobes, and shows a good transfer into intrauterine tissues, and high clinical efficacy in the field of obstetrics and gynecology.(ABSTRACT TRUNCATED AT 250 WORDS)

Forensic Sci Int, 1986 Aug-Sep, 32(1), 5 - 11
Microbial production of hydroxy and oxo fatty acids by several microorganisms as a model of adipocere formation; Takatori T et al.; Some varieties of aerobic or anaerobic microorganisms from the human stool and adipocere were separated and identified . These separated microorganisms together with other authentic ones produced 10-hydroxystearic acid from oleic acid . Some bacteria could convert oleic acid to 10-oxostearic acid as well as 10-hydroxystearic acid . These findings indicate that the microbial enzyme(s) catalyzes the hydration of oleic acid and probably the oxidation of this hydrated product . Aerobic bacteria as well as anaerobic microorganisms were found to be involved in the formation of adipocere.

Am J Med, 1986 Jul 28, 81(1A), 39 - 44
Infection in postoperative patients; Stone HH; The majority of surgical infections are due to multiple bacterial pathogens, usually represented by mixtures of both aerobic and anaerobic species . Contamination from endogenous sources accounts for the majority of these infections . The most virulent of all such sepsis appears to arise from a symbiosis between aerobic gram-negative rods and various anaerobes . Antibiotics have proved efficacy in both the treatment as well as the prevention of surgical infection . The choice of antimicrobial agent(s) should be based upon the drug's spectrum of activity against known or anticipated pathogens, the biologic half-life of the agent, which serves as a guide to the frequency of administration, and the drug's safety . The third-generation cephalosporins have been shown to be especially useful because of their broad spectrum of activity, prolonged half-life, and limited toxicity . Sepsis that persists or is uncontrolled despite antibiotic administration often leads to failure of multiple organ systems . Only energetic surgical measures offer any real chance for patient survival when such a stage has been reached.

Cell Tissue Kinet, 1986 Jul, 19(4), 485 - 90
The tropic effect of intrarectal deoxycholate on rat colorectum is unaffected by oral metronidazole; Rainey JB et al.; Intrarectal administration of sodium deoxycholate (SDC) enhances experimental colorectal carcinogenesis, an effect that is partly vitiated by oral metronidazole . The effect of topical SDC with or without concurrent metronidazole on colorectal cell proliferation was explored in male Sprague-Dawley rats (n = 30) allocated to five groups . Two groups received thrice weekly intrarectal instillations of 1 ml N saline or 1 ml 0.12 M SDC . A third group received SDC plus metronidazole 22.5 mg/kg/day in the drinking water . Controls had no instillations or metronidazole alone . At time of killing (10 weeks), crypt cell production rate (CCPR) was determined by the stathmokinetic technique for four large-bowel segments . Saline had no significant effect on colorectal CCPR but SDC produced increases throughout, varying from 53% in the proximal colon to 222% in the rectum (P less than 0.01) . Metronidazole did not reduce this effect, although given alone it reduced colonic CCPR by 40 to 50% . The direct tropic effect of bile acids could largely explain their cocarcinogenic properties . Since metronidazole does not prevent this increase in cell proliferation, its mildly protective role against cancer may reflect the presence of fewer anaerobes capable of degrading bile acids to carcinogenic metabolites.

J Pediatr Surg, 1986 Jul, 21(7), 596 - 600
Drainage of pediatric lung abscess by cough, catheter, or complete resection; Kosloske AM et al.; We treated eight children, aged 7 weeks to 17 years, for lung abscess . Each abscess followed an episode of aspiration or a bacterial pneumonia . Associated conditions were leukemia, congenital immune deficiency, endocarditis, cerebral palsy, and prematurity . Seven of the 8 children had polymicrobial infections, usually containing both aerobic and anaerobic bacteria . The success of medical treatment by antibiotics and chest physiotherapy was age related; 3 of the 8 children, aged 10 to 17 years, recovered on this regimen, whereas five children, aged 7 weeks to 7 years, required catheter drainage or resection for cure . Drainage by catheter pneumonostomy was performed for solitary peripheral bacterial abscesses . A large intercostal catheter was inserted into the cavity, either operatively or percutaneously . Wedge resection was performed for multiple, central, or fungal abscesses . Pneumonostomy was curative in 3 of 4 children . One chronic abscess recurred after pneumonostomy and required resection . Wedge resection was curative in the two children who came to thoracotomy; lobectomy was not necessary . Although all eight children recovered from their lung abscesses, three of them died within a year of sepsis . Lung abscess today occurs in immunocompromised children who are vulnerable to fatal infections . Chest physiotherapy is unlikely to achieve good drainage in children under 7 years of age . Medical failures can be identified within the first week of treatment . Early and aggressive surgical treatment is indicated in such children, and may be lifesaving.

Dis Colon Rectum, 1986 Jul, 29(7), 451 - 3
Preoperative antimicrobial preparation of the colon with povidone-iodine enema; Orsay CP et al.; To evaluate the efficacy of povidone-iodine enemas as a means of preoperative bowel preparation in colonic surgery, 52 mongrel dogs were randomized into two groups . Group 1 received oral neomycin-erythromycin combinations in the usual clinical doses, while Group 2 received a single 500-ml 5 percent povidone-iodine enema preoperatively . Quantitative bacterial counts obtained at the time of colonic resection revealed that povidone-iodine was equally effective in reducing the anaerobes, but was significantly superior to neomycin-erythromycin combinations in reducing the aerobic colony counts . Bursting pressures, measured three weeks later, were equal in both groups . Despite elevated blood-iodine levels, no systemic toxicity was noted in Group 2 dogs . It is concluded that half-strength povidone-iodine, given as a single enema preoperatively, is equally effective as standard preoperative antibiotic preparations and may be the ideal preparation in urgent or emergency colonic operations . Due to reported toxicity of povidone-iodine in burn wounds, we suggest that initial trials be limited to emergency cases where the potential benefits possibly will be greater than the theoretic risk of iodine toxicity.

J Antimicrob Chemother, 1986 Jul, 18(1), 17 - 25
Satranidazole: mechanism of action on DNA and structure-activity correlations; Zahoor A et al.; Satranidazole (CG-10213-Go), a novel nitroimidazole possessing a C-N linkage at C2 of the imidazole ring has been examined, during reduction, for its ability to damage DNA . Physical damage to DNA was measured by viscometry, thermal denaturation and renaturation, and hydroxyapatite chromatography . Biologically relevant DNA damage was measured by a bacteriophage transfection assay . The drug produces extensive DNA damage characterized by helix destabilization and strand breakage . Its comparison with other 2- and 5-nitroimidazoles indicate it may be more active towards anaerobes than many 5-nitroimidazoles because its relatively high redox potential may make it more resistant to inactivation by oxygen.

G Batteriol Virol Immunol, 1986 Jul-Dec, 79(7-12), 228 - 43
{In vitro activity of imipenem (N-formimidoylthienamycin), a new carbapenem antibiotic}; Cavallo R et al.; Imipenem is a beta-lactam carbapenem antibiotic, N-formimidoyl thienamycin-derivate . Imipenem is highly active against gram-negative aerobes and also highly active against gram-positive aerobes and virtually all anaerobes, with MICs very low and MBCs equal or only two-four dilution higher, it has a low degree of affinity for all types of beta-lactamases, shown a good post-antibiotic effect, it is a potent inhibitor to peptidoglycan with a greatest affinity for PBP2 and PBP1, in gram-negative bacteria, and for PBP3, PBP1 and PBP4, in gram-positive bacteria . The precocious bactericidal activity belongs to its low molecular weight, the characteristic of zwitterionic compound, to its hydrophobicity and to, in finally, its compact molecular structure.

Br Med J (Clin Res Ed), 1986 Jun 21, 292(6536), 1640 - 2
Contribution of Gardnerella vaginalis to vaginitis in a general practice; O'Dowd TC et al.; In a study of 154 adult women who presented to their general practitioner with vaginal symptoms 30 (20%) had Gardnerella vaginalis on its own and 51 (33%) had G vaginalis in combination with anaerobes or known pathogens . Thirty one (20%) patients were culture negative . Those who were culture negative had fewer symptoms and signs of vaginitis than those with G vaginalis alone or G vaginalis plus anaerobes . Those with known pathogens had more symptoms and signs than those with G vaginalis alone or G vaginalis plus anaerobes . Those with known pathogens plus G vaginalis had the most severe signs and symptoms of vaginitis . It is concluded that G vaginalis can cause vaginitis on its own, and it makes vaginitis worse when present with other organisms . G vaginalis was also found in 30 (21%) of the 138 control patients who, although they presented "asymptomatically," had worse signs than control patients without G vaginalis . It seems that G vaginalis can occur in a spectrum ranging from the uncomplaining patient to those with severe vaginitis.

J Biol Chem, 1986 Jun 15, 261(17), 7866 - 70
Purification of a nickel-containing urease from the rumen anaerobe Selenomonas ruminantium; Hausinger RP; Urease was purified 592-fold to homogeneity from the anaerobic rumen bacterium Selenomonas ruminantium . The urease isolation procedure included a heat step and ion-exchange, hydrophobic, gel filtration, and fast protein liquid chromatography . The purified enzyme exhibited a Km for urea of 2.2 +/- 0.5 mM and a Vmax of 1100 mumol of urea min-1 mg-1 . The molecular mass estimated for the native enzyme was 360,000 +/- 50,000 daltons, whereas a subunit value of 70,000 +/- 2,000 daltons was determined . These results are in contrast to the findings of Mahadevan et al . (Mahadevan, S., Sauer, F . D., and Erfle, J . D . (1977) Biochem . J . 163, 495-501) in which isolated rumen urease was reported to be one-third this size (Mr 120,000-130,000) and to catalyze urea hydrolysis at a maximum velocity of only 53 mumol min-1 mg-1 . S . ruminantium urease contained 2.1 +/- 0.4 nickel ions/subunit, comparable to the nickel content in jack bean urease (Dixon, N.E., Gazzola, C., Blakeley, R.L., and Zerner, B . (1975) J . Am . Chem . Soc . 97, 4131-4133) . Thus, the active site of bacterial urease is very similar to that found in the plant enzymes.

Jpn J Antibiot, 1986 Jun, 39(6), 1531 - 54
{Pharmacokinetic and clinical studies of imipenem/cilastatin sodium in the field of obstetrics and gynecology}; Obata I et al.; Imipenem/cilastatin sodium (MK-0787/MK-0791) was studied for its penetration into the adnexa uteri and uterine tissue, as well as for its clinical efficacy in the treatment of patients with obstetric and gynecologic infections . The following results were obtained . When 500 mg/500 mg of MK-0787/MK-0791 was administered by an intravenous drip infusion, peak levels of MK-0787 in tissues of adnexa uteri and uterus ranged from 14.6 micrograms/g to 25.8 micrograms/g, Tmax ranged from 0.55 hour to 0.98 hour, and the AUC ranged from 25.6 micrograms X hr/g to 45.2 micrograms X hr/g . Thus, the penetration of the drug into these tissues was good . Clinical efficacy of MK-0787 was evaluated in 30 patients in the field of obstetrics and gynecology . The clinical efficacy was excellent or good in all patients . Bacteriological effects of MK-0787/MK-0791 were very good, and 90% of the organisms detected before the treatment were eradicated . The antimicrobial activity of MK-0787 was tested against pathogens isolated before, during and after the treatment . Mean MIC80 values of MK-0787 were 0.39-0.78 micrograms/ml against all Gram-positive bacteria, 0.20-0.39 micrograms/ml against all Gram-negative bacteria, and less than or equal to 0.10-0.20 micrograms/ml against all anaerobic bacteria . The antimicrobial activity of MK-0787 appeared very good . No side effects or abnormal laboratory findings were observed except a slight elevation of S-GPT in 1 patient.

Acta Chir Scand, 1986 May, 152, 351 - 5
Mononuclear phagocyte thromboplastin, bacterial counts and endotoxin levels in experimental endogenous gram-negative sepsis; Almdahl SM et al.; The relationship between mononuclear phagocyte thromboplastin activity, microorganisms and levels of endotoxin in peritoneal fluid and splanchnic and systemic circulation was evaluated during experimental endogenous gram-negative peritonitis in the rat . Significant rise in thromboplastin activity of mononuclear phagocytes was demonstrated in all three compartments . This newly synthesized thromboplastin is a trigger for important biologic systems such as the coagulation cascade, and thus may play a major role in the development of disseminated intravascular coagulation so often occurring in gram-negative sepsis . It probably also participates in the formation of fibrous intraabdominal adhesions . Aerobic and anaerobic microorganisms together with endotoxin were detected already 1 1/2 hours after induction of peritonitis, and subsequently were found to increase in parallel fashion . Determination of endotoxin is a rapid and seemingly reliable method for early detection of gram-negative infection and thus may be of clinical value.

J Clin Pathol, 1986 May, 39(5), 535 - 41
Isolation and characterisation of intestinal spirochaetes; Tompkins DS et al.; Faeces or rectal swabs from 1527 subjects were examined for the presence of intestinal spirochaetes by anaerobic culture on blood agar incorporating spectinomycin (400 mg/l) . Twenty three specimens (1.5%) were positive, and only one of these came from a patient with diarrhoea . All positive specimens came from either Asians or known homosexuals . Comparative tests showed a close phenotypic similarity between the human isolates and non-pathogenic porcine intestinal spirochaetes . These organisms differ from Brachyspira aalborgi, a spirochaete isolated from subjects with histologically confirmed intestinal spirochaetosis.

Diagn Microbiol Infect Dis, 1986 May, 5(1), 9 - 15
Evaluation of the AnIdent system for the identification of anaerobic bacteria; Stenson MJ et al.; AnIdent is a new 4-hr system for the identification of anaerobic bacteria that depends upon detection of a unique set of preformed enzymes . A single AnIdent test speciated 76% of 333 anaerobes (89% agreement with a conventional system used at the Mayo Anaerobe Laboratory) without any repeat or supplemental testing (level 1) . Additional testing increased the identification rate to 93% (level 2) . We conclude that AnIdent is a reliable method for identifying clinically significant anaerobes which only occasionally requires the use of a small number of simple supplemental tests and avoids the necessity for performing gas-liquid chromatography.

Diagn Microbiol Infect Dis, 1986 May, 5(1), 31 - 8
Quantitative microbiology of pressure sores in different stages of healing; Sapico FL et al.; The quantitative microbiology of 25 pressure sores in different stages of healing was examined in 25 patients with spinal cord injury . When grossly necrotic tissue was present (stage 1), 5.8 isolates per patient with a density of 6.4 log10/g was recovered, with comparable findings for aerobes and anaerobes . In the absence of necrotic tissue but with the presence of undermining (stage 2), 1.5 aerobic and 0.2 anaerobic isolates were recovered per patient with a mean density of 2.7 and 0.1 log10/g of tissue for aerobic and anaerobic isolates, respectively . The lesions were almost sterile in patients with no necrotic tissue and no undermining (stage 3) . Foul smell was always associated with the presence of anaerobes in deep tissue cultures, however, six patients with nonfoul-smelling lesions yielded anaerobes . A 75% quantitative concordance was seen between swab and biopsy culture results . The quantitative concordance between peripheral and central biopsy culture results was 63%, showing variability in results from different sampling areas . No relationship was observed between the density of microorganisms and the eventual outcome of the myocutaneous flap procedure.

Drugs, 1986 May, 31(5), 449 - 54
Biliary sepsis . Reviewing treatment options; Munro R et al.; Bactobilia is a frequent accompaniment of obstruction in the biliary tract, organisms present being normal intestinal aerobes and anaerobes . Bacterial colonisation of the bile may occur asymptomatically, may predispose to infection postoperatively, or may be associated with an attack of acute cholecystitis, occurring secondary to obstruction . The choice of an antimicrobial regimen for biliary infection should take into account the expected antibiotic sensitivities of organisms colonising bile, whether biliary obstruction or bacteraemia is present, and the activity of the antibiotic in bile . Often, high biliary concentrations of an antibiotic cannot be achieved due to obstruction, and in many cases high blood and tissue concentrations are of greater importance . Surgical prophylaxis should be reserved for patients at high risk of bactobilia (e.g . the elderly), when obstruction is present, for immunosuppressed patients, and those with artificial heart valves . A single perioperative dose of a 'first' or 'second generation' cephalosporin, gentamicin, or co-trimoxazole is effective . Antibiotic therapy for acute cholecystitis should be instituted if there is evidence of systemic toxicity, when surgery is to be delayed, or in patients with identified risk factors for bactobilia . Ampicillin or a cephalosporin may be appropriate in less severe disease, while in seriously ill patients, an aminoglycoside or cephalosporin with metronidazole or clindamycin is appropriate . Oral regimens include amoxycillin, an oral cephalosporin, or co-trimoxazole, in combination with metronidazole . In acute cholangitis, systemic therapy similar to that recommended for acute cholecystitis is indicated . Patients with recurrent cholangitis may have relatively antibiotic-resistant bacteria and efforts should be made to obtain a bacteriological diagnosis . Long term suppressant therapy with oral agents such as amoxycillin, cephalexin, or co-trimoxazole may be tried.

Laryngoscope, 1986 Apr, 96(4), 438 - 42
Role of aerobic and anaerobic microorganisms in chronic suppurative otitis media; Papastavros T et al.; This study reports results of cultures of drainage from 119 cases with chronic otitis media . Mixed infections were found to occur 30 times more frequently among cholesteatomatous cases compared to noncholesteatomatous . A significant association was found between prior use of gentamicin ear drops and bacterial resistance to the drug . The role of aerobes and anaerobes in mixed infections of cholesteatomatous ears is discussed . The relevant literature is critically reviewed and the mechanisms of synergistic anaerobic infections of the ear are summarized . The need for animal studies of bacterial pathogenicity and parallel human studies of response to rational medicinal treatment is stressed.

Burns Incl Therm Inj, 1986 Apr, 12(4), 270 - 2
The management of anaerobic infection in extensive burns; Ramakrishnan KM et al.; A survey of 300 patients with burns covering more than 30 per cent of the body surface area indicated that 33 patients had proven wound infection with anaerobic bacteria and 11 patients showed positive blood cultures . Although metronidazole was the anti-bacterial agent of choice for treating these 33 patients, treatment was not always successful since 7 patients died . The most common sites of infection were the perineum and upper parts of the legs.

J Clin Microbiol, 1986 Mar, 23(3), 619 - 21
Evaluation of the 10-micrograms clindamycin disk for susceptibility testing of anaerobes by the aerobically incubated thioglycolate broth disk method; Toohey KL et al.; The reliability of the 10-micrograms clindamycin disk was evaluated for susceptibility testing of anaerobes by the aerobic thioglycolate broth disk method . A good correlation between the aerobic thioglycolate broth disk method and the reference agar dilution procedure of the National Committee for Clinical Laboratory Standards was obtained by using a 4-microgram/ml breakpoint . Improved correlation was obtained when the medium of the National Committee for Clinical Laboratory Standards was buffered.

J Clin Microbiol, 1986 Mar, 23(3), 523 - 30
Quantitative gas chromatographic analysis of volatile fatty acids in spent culture media and body fluids; van den Bogaard AE et al.; Gas chromatographic analysis of volatile fatty acids for identification of obligately anaerobic bacteria and for presumptive diagnosis of anaerobic infections is now widely practiced . However, it is difficult to compare data because only a qualitative analysis is done or only chromatograms are presented instead of quantitative data on volatile fatty acid production . We compared three stationary phases for volatile fatty acid analysis of aqueous solutions and four methods of pretreating samples for gas chromatography . Quantitative analysis could be done accurately by using Carbowax as the stationary phase after pretreatment of spent culture media with Dowex columns . If only qualitative analysis is required (e.g., for presumptive diagnosis of anaerobic infections), ether extraction and headspace analysis are equally suitable . The overall variation coefficient for volatile fatty acid production by four reference strains of obligately anaerobic bacteria after 24 h of incubation was approximately 10%.

Dis Colon Rectum, 1986 Mar, 29(3), 165 - 9
The effect of peritoneal lavage with tetracycline solution on postoperative infection . A prospective, randomized, clinical trial; Silverman SH et al.; A prospective randomized trial was performed to determine the value of tetracycline lavage in addition to systemic antibiotic prophylaxis in 159 patients undergoing elective and emergency intestinal operations . Tetracycline lavage was associated with a significant overall reduction in postoperative infection rates in 25 of 74 patients (34 percent) receiving saline lavage compared with 15 of 85 patients (18 percent) having tetracycline lavage (P less than 0.05) . Tetracycline lavage was associated with a significant reduction in the counts of aerobic and anaerobic bacteria in the peritoneal fluid at the end of the operation (P less than 0.05 and P less than 0.01, respectively) and with a significant reduction of aerobes 24 hours postoperatively (P less than 0.02) . Tetracycline lavage would appear to confer clinical benefit in preventing postoperative infection.

Ann Inst Pasteur Microbiol, 1986 Mar-Apr, 137A(2), 117 - 23
A comparison of the distribution of extracellular proteins produced by the protease-secreting organism Aeromonas salmonicida during aerobic and anaerobic growth; Fyfe L et al.; Aeromonas salmonicida was grown aerobically and anaerobically in supplemented 3% (w/v) tryptone soya broth medium for 24 h at 25 degrees C . Although the bacterial density achieved was 4.9 times higher in the aerobic culture, the exoprotein produced per unit of bacterial dry weight was only 1.9 times higher than in the anaerobic culture . However, the protease activity of the exoprotein showed a marked reduction anaerobically, being only one-tenth of that of the exoprotein produced aerobically . This finding was consistent with the differing SDS-PAGE patterns of the extracellular proteins from the two cultures, which also showed marked loss and reinforcement of other, as yet unidentified extracellular products.

Microbiol Sci, 1986 Mar, 3(3), 88 - 92
Pathogenic anaerobic bacteria of man; Watt B et al.; A range of anaerobic bacteria may be pathogenic to man . Those of particular clinical significance are reviewed and prospects for their control by antibiotic therapy discussed.

Aust N Z J Surg, 1986 Mar, 56(3), 209 - 13
Clinical trial of prophylaxis of wound sepsis in elective colorectal surgery comparing ticarcillin with tinidazole . University of Melbourne Colorectal Group; Cytochrome-free mitochondria of an anaerobic protozoan--Blastocystis hominis; Isolated mitochondria of the anaerobic protozoan Blastocystis hominis were subjected to spectral analysis, color, catalase, and peroxidase tests and found to be completely negative for cytochrome enzymes, catalase, and peroxide . Based on the absence of cytochrome enzymes, the possible evolution of B . hominis mitochondria from anaerobic bacteria is postulated.

Appl Environ Microbiol, 1986 Feb, 51(2), 340 - 5
Rumen microbial changes in cattle fed diets with or without salinomycin; Olumeyan DB et al.; Four rumen-fistulated steers, randomly assigned to two groups (control and salinomycin fed) were used to monitor the changes in rumen microbial populations and volatile fatty acids (VFA) concentrations associated with feeding salinomycin (0.22 mg X kg-1 X day-1) . Steers were adapted to an alfalfa hay and grain (80:20) diet before supplementing the diet with salinomycin, and then the diet was changed to 50:50 and 20:80 ratios of alfalfa hay to grain at 2-week intervals . Rumen samples for total and selective enumeration of anaerobic bacteria . VFA analysis, and enumeration of protozoa were collected during the 80:20 alfalfa hay-to-grain diet before salinomycin feeding, and during the 80:20, 50:50, and 20:80 hay-to-grain diets with salinomycin . At each sampling period, rumen samples were collected at 3 h after feeding on three consecutive days . Salinomycin feeding had no effect on rumen pH and total VFA concentration . The acetate-to-propionate ratio was significantly lower in salinomycin-fed steers than in the control . The molar proportion of butyrate increased in both control and salinomycin-fed steers . Total anaerobic bacterial counts were lower in salinomycin-fed steers than in the control steers after 8 weeks of salinomycin feeding . Salinomycin-resistant bacteria increased from 7.6 to 15.6% in salinomycin-fed steers but remained unchanged in control steers . Salinomycin had no effect on cellulolytic and lactate-utilizing bacteria, but the proportion of amylolytic bacteria was higher in salinomycin-fed steers than in control steers . The total number of protozoa decreased initially in salinomycin-fed steers . The initial reduction was due to reduced numbers of Entodinium species . Holotrichs were unaffected by salinomycin feeding.

J Clin Microbiol, 1986 Feb, 23(2), 392 - 4
Modified extraction procedure for gas-liquid chromatography applied to the identification of anaerobic bacteria; Thomann WR et al.; Chloroform and ether commonly are used as solvents to extract metabolic organic acids for analysis by gas-liquid chromatography in the identification of anaerobic bacteria . Because these solvents are potentially hazardous to personnel, modified extraction procedures involving the use of a safer solvent, methyl tert-butyl ether were developed which remained both simple to perform and effective for organism identification.

Z Kinderchir, 1986 Feb, 41(1), 14 - 8
{Antibiotic treatment of perforated appendicitis in childhood--a prospective study}; Hollwarth M et al.; A prospective randomised study (I) was carried out on 130 children undergoing laparotomy for perforated appendicitis . The present study evaluates the therapeutic effectiveness of different antibiotic regimens in modifying the rate of post-operative complications (intraabdominal abscess, ileus, wound infiltration or abscess) . During the first year of this study two treatment groups were used . Group A consisted of 29 children treated with Sulfometrol/Trimethoprim; the rate of postoperative complications was 44.8% . Group B consisted of 36 children treated with mezlocillin, the rate of complications being 13.8% . However, the same treatment with mezlocillin during the second year of the prospective study showed an increase of this rte to 39% (28 children--group C) . The final group of 37 children was treated during the second year with mezlocillin and metronidazole (group D) . The postoperative rate of complications was 10.8% . A retrospective analysis of further 80 children (study II) with perforated appendicitis treated with mezlocillin and metronidazole showed a consistent low rate of postoperative complications at 10.2% . In 6.8% of children studied, an operative intervention was necessary (four cases of ileus, four wound abscesses) . The mean postoperative hospitalisation period decreased from 22.7 days in group A to 15.2 days in group D and finally to 14 days in study II . The present study shows that an effective and persistent attenuation of the rate of postoperative complications after perforated appendicitis in children depends on an early onset of therapy and on the appropriate choice of antibiotic drugs that are effective against aerobic and anaerobic microorganisms.

Eur J Clin Pharmacol, 1986, 29(5), 625 - 8
Single dose prophylaxis with metronidazole in infants during abdominal surgery: a pharmacokinetic study; Rubenson A et al.; Plasma metronidazole was measured following a single intravenous dose of 20 mg/kg (Flagyl 5 mg/ml) in 12 infants less than 1 year of age undergoing abdominal surgery . In all patients sufficient plasma concentrations, well above the MIC values for anaerobic bacteria, were found for at least 16 h . A prolonged half-life was demonstrated in the group less than 8 weeks of age (t1/2/18.4 h) . The group over 8 weeks of age demonstrated a t1/2 comparable to that seen in adults (t1/2 7 h).

Microbiologica, 1986 Jan, 9(1), 63 - 70
The predominant cultivable microbial population of adult periodontitis; Gulletta E et al.; An extensive characterization of the cultivable microbial population, present in gingival pockets of a selected group of eight patients with periodontal disease, has been performed . The result obtained, from samples collected from six different periodontal sites in each patient, indicate a great prevalence of anaerobic bacteria . It is likely that the presence inside the gingival pockets of anaerobic cocci, to which the rods are capable of a selective coaggregation mechanism, creates conditions favorable to the proliferation of the latter type of bacteria . These findings suggest that the evolution of adult periodontitis is based on a chronic inflammatory stimulus and the necrosis of gingival epithelium caused by the proliferation of the anaerobic rods.

Fertil Steril, 1986 Jan, 45(1), 97 - 100
Sperm washing and swim-up technique using antibiotics removes microbes from human semen; Wong PC et al.; Pelvic infections may follow intrauterine or intratubal insemination with washed semen . In this study, we determined whether sperm washing removes microorganisms from human semen . Before and after semen wash, we cultured 15 ejaculates for aerobic and anaerobic bacteria, genital mycoplasma, and chlamydia . All semen samples had from one to five organisms isolated (total, 40 isolates) before the semen wash preparation . The mean number (+/- standard deviation) of isolates per sample was 2.67 +/- 1.35 . After the semen were prepared, none of the samples showed a positive culture . The decrease in the number of samples with positive cultures and the decrease in the number of isolates is significant (P less than 0.0001) . After sperm washing, electronmicroscopic studies did not show any microbes attached to any portion of the spermatozoa . We conclude that the method of sperm wash preparation used is effective in removing microbes present in human semen.

Rev Pneumol Clin, 1986, 42(5), 219 - 25
{Thoracic actinomycosis . Apropos of 5 cases}; Massart V et al.; Described for the first time by Bradshaw in 1846, actinomycosis is a rare, slowly progressing disease associated with the development of anaerobic bacteria of the Actinomyces genus . It predominates in males and is actively encouraged by poor buccal and dental hygiene and by overall decline of defence mechanisms . Thoracic lesions constitute 15 to 20% of the cases and seem to be relatively increasing . Apart from fistulization to the skin, physical examination usually does not show much; only the presence of yellow grains suggests the diagnosis . Radiography is often misleading, suggesting tuberculosis or cancer . Ultrasonography and, chiefly, computerized tomography are the best methods to evaluate the extension of the disease to the pleura, the chest wall and the mediastinum . The final diagnosis is more often supplied by pathological examination than by bacteriology, which is frequently negative . Treatment is facilitated by the fact that Actinomyces is sensitive to antibiotics, notably to penicillin which still is the first choice drug . A well-conducted treatment will give satisfactory results, but sequelae of retractile fibrosis may be disabling.

Drugs, 1986, 32 Suppl 3, 33 - 8
Treatment of acute and chronic sinusitis with cefadroxil; Kaminszczik I; In an open study, 30 patients (mean age 43.7 years) with clinical and radiological evidence of sinusitis were studied by transmaxillary sinus aspirations (19 bilateral and 11 unilateral for a total of 49 aspirates) . The sinus aspirations were performed with careful sterile intermeatus needle puncture techniques and the material was cultured for aerobic and anaerobic bacteria . The organisms most frequently recovered from the sinus aspirates were Gram-positive (55%), Gram-negative (33%), and anaerobes (6%) . Cefadroxil 1g was given every 12 hours (2g daily) for 10 days . Therapeutic efficacy was then evaluated on the basis of changes in clinical status, radiographic findings and, where possible, bacteriological results . Cefadroxil treatment produced a 90% cure rate assessed clinically and by radiological confirmation; moreover, the drug was well tolerated in the majority of patients.

Am J Vet Res, 1986 Jan, 47(1), 35 - 8
Alveolar phospholipids of 17-day-old pigs exposed to microorganisms of nonpulmonic origin; Engen RL et al.; Alveolar lining material was obtained from gnotobiotic pigs; gnotobiotic pigs exposed to aerobes, anaerobes, or mixtures of both microorganisms; and conventional farm-raised pigs . Alveolar lining material concentrations of phosphatidylcholine, sphingomyelin, phosphatidylserine, phosphatidylinositol, phosphatidylethanolamine, phosphatidylglycerol, and lysolecithin were determined . Seventy-four pigs were allotted to the following groups: 1--gnotobiotes (n = 13), 2--gnotobiotes with aerobes (n = 6), 3--gnotobiotes with anaerobes (n = 31), 4--gnotobiotes with anaerobes and aerobes (n = 2), 5--gnotobiotes with facultative anaerobes (n = 9), and 6--conventionally farm-farrowed (n = 13) . The conventionally raised pigs had lysolecithin, sphingomyelin, and phosphatidylinositol concentrations that were significantly different from those of all other groups of pigs . Phosphatidylethanolamine was significantly decreased in group 6 pigs when compared with that in all other groups . There were also statistically significant differences between the gnotobiotic (group 1) and the exposed gnotobiotic (groups 2, 3, 4, 5) pigs, although the differences were less pronounced . Since intestinal microbes produce alveolar lining material phospholipid differences, studies need to be concerned with phospholipid changes that occur after exposure to lung-specific microorganisms and with physiologic changes in lung function associated with the phospholipid changes.

Int Surg, 1986 Jan-Mar, 71(1), 53 - 8
The role of hyperbaric oxygen in the management of Fournier's gangrene; Eltorai IM et al.; Fournier's gangrene of the external genitals is a complex entity characterized by acute onset, rapid progress to gangrene, toxemia and high mortality rate . The disease may be primary as described by Fournier or secondary with a detectable cause in the colo-rectal area, the lower urogenital tract or in the perineum . The disease may affect healthy young males (originally described by Fournier) or elderly subjects especially with general ill health, cancer, diabetes, liver or renal failure, immunosuppression, etc . The microbiology is as complex as the etiology . The nosiology is likewise complex . Because the mortality is high, it is important to be aggressive in therapy . Triple attack is necessary, viz.: antibiotic coverage for aerobes and anaerobes, general supportive measures and adequate surgical debridement . We, recommend Hyperbaric Oxygen Therapy (HBO) treatment in specialized centers as an adjunctive measure since we had no mortality in the cases we treated . In expert centers, HBO has very few complications which are outweighed by the benefit the patient gets . The one-man chamber is the commonest in use, but for a compromised patient the multiplace may be more appropriate . In the very early stage, HBO may avert gangrene or reduce it . It is important to have a high index of awareness of this disease amongst the medical profession . More work is needed for the more precise definition, classification and management of the complex syndrome of Fournier.

Trans R Soc Trop Med Hyg, 1986, 80(5), 793 - 4
Anaerobic bacteria in tropical ulcer--the application of a new transport system for their isolation; Adriaans B et al.; The successful isolation of anaerobes largely depends on adequate transportation of the specimens after collection . We are investigating the role of anaerobes in the pathogenesis of tropical ulcer and have used Hungate tubes with pre-reduced peptone yeast broth and agar as a transportation system . The medium included 0.05% cysteine and 0.03% sodium formaldehyde sulphoxylate as an Eh buffer . Resazurin 1 microgram/ml seved as an Eh indicator . We found the tubes convenient to use and very reliable at maintaining anaerobiasis.

Chir Pediatr, 1986, 27(3), 153 - 6
{Treatment of acute perforated appendicitis with intraperitoneal cefazolin}; Ducharme JC et al.; Until recently intra-abdominal sepsis following surgery for perforated appendicitis has remained a frequent occurrence . In 1975 Fowler reported an incidence of one intra-abdominal abscess in 36 perforated appendicitis treated with a protocol consisting of saline irrigation at surgery, followed by intraperitoneal administration of cephaloridine q . 6 hours for 48 hours . The same antibiotic was then given i.v . for 72 hours . He concluded that this method was an effective way to minimize post-op intra-abdominal abscess, and that the intraperitoneal route was more effective, for this purpose, than systemic administration . More recently, with better knowledge of the role of anaerobes, improved results have also been obtained by adding clindamycin or metronidazole to the antibiotic regimen . A prospective study based on two groups of patients randomly assigned to two protocols was undertaken . The study group consisted of 45 children operated for perforated appendicitis with abscess or generalized peritonitis . These patients were treated with Fowler's protocol . Because it is less nephrotoxic and is active against the same organisms, cefazolin was used instead of cephaloridine . The control group consisted of 43 patients, also operated for perforated appendicitis, treated with saline irrigation at surgery, with either i.v . gentamycin or tobramycin and clindamycin or metronidazole for an average of 7.8 +/- 3.1 days . Both groups were fairly well matched in terms of age, sex, severity of disease, and bacterial flora . They showed an identical 6% post-op intra-abdominal sepsis rate . Days before afebrile, days under gastric suction, complications and average hospital stay were comparable in both groups . The wound infection rate was 20% in the study group and 9% in the control group.(ABSTRACT TRUNCATED AT 250 WORDS)

Int Surg, 1986 Jan-Mar, 71(1), 18 - 21
The place of antibiotics in the prevention of post-appendicectomy sepsis: a prospective study of 400 cases; el-Sefi TA et al.; Post-appendicectomy sepsis still causes considerable morbidity and prolongs hospital stay . A large amount of recent work has gone into attempts to reduce such problems using various topical and systemic agents in differing regimes, with wide variation in their results . The aim of our study was to examine further the effectiveness of those different lines of prophylaxis against placebo in reducing post-appendicectomy sepsis . It is a comparative study of 400 cases of uncomplicated appendicitis operated upon by three senior Surgeons . The cases were allocated randomly in equal number to four groups according to the prophylactic antibiotic regime used: (a) Placebo; (b) Metronidazole alone; (c) Metronidazole and cefazolin; (d) Metronidazole and tobramycin . Antibiotics were given preoperatively with premedication and continued postoperatively for three days . The patients were checked for signs of sepsis during hospital stay and weekly up to a minimum of four weeks after discharge . They were also compared as far as their hospital stay is concerned . The conclusion of this study is that a combination of an antibiotic aimed at aerobes (cefazolin or tobramycin) with another aiming at anaerobes (metronidazole) is the best prophylactic regime against post-appendicectomy sepsis.

Zh Mikrobiol Epidemiol Immunobiol, 1986 Jan, (1), 20 - 4
{Head-space gas chromatographic analysis in the rapid diagnosis of anaerobic infections}; Vitenberg AG et al.; The comparison of the results obtained by the gas-chromatographic vapor-phase analysis and by the bacteriological analysis of exudate samples, taken from patients with intraperitoneal and intrapleural infections, has demonstrated high reliability of the chromatographic method . Despite the presence of some discrepancies between the results of the vapor-phase analysis and the bacteriological analysis due to the difficulties of the microbiological isolation of anaerobes and the specific features of their metabolism, the diagnostic value of the gas-chromatographic method has been confirmed.

Health Phys, 1986 Jan, 50(1), 79 - 88
Interactions of Escherichia coli and marine bacteria with 241Am in laboratory cultures; Wurtz EA et al.; In nutrient media, Escherichia coli and selected strains of marine facultative anaerobes accumulated significant amounts of the transuranic radioisotope 241Am . The pattern of uptake varied among strains and was dependent upon pH, culture media and growth stage of the population . Desorption of 241Am to montmorillonite was significantly less in filtered media from some bacterial cultures than in "unconditioned" control media, suggesting that bacterial exometabolites may form complexes with Am thereby increasing its solubility.

Surgery, 1986 Jan, 99(1), 20 - 5
Washing with or without chloramphenicol in the treatment of peritonitis: a prospective, clinical trial; Nomikos IN et al.; One hundred one suitable patients with peritonitis of diverse origin were randomized into two groups . In each patient in group 1 (50 patients), the abdomen was washed after the appropriate surgical procedure with normal saline solution, and 2 gm chloramphenicol was introduced before abdominal closure; in each patient in group 2 (51 patients), the abdomen was washed as in group 1, but chloramphenicol was not instilled . All patients were given 1 gm chloramphenicol intramuscularly either preoperatively or intraoperatively and 3 gm daily for 3 days . Chloramphenicol was selected on the basis of its activity against aerobic and anaerobic bacteria and its demonstrated stimulating effect on peritoneal macrophages in vitro . All explorations were done through the midline, and the skin and subcutaneous tissues were closed secondarily 3 to 4 days after operation . No drains were used . The two groups were roughly comparable, but results were significantly better for all parameters studied in patients receiving chloramphenicol locally . Blood dyscrasias were not observed . It is suggested that the combination of washing and local antibiotics is superior to washing alone; in addition to its parenteral administration, chloramphenicol is of considerable value if instilled in the area of peritonitis after washing; and besides its bacteriostatic action, chloramphenicol may have a local stimulating effect on peritoneal defenses and may therefore be the drug of choice for local use in generalized peritonitis.

Scand J Plast Reconstr Surg, 1986, 20(3), 297 - 302
Bacteriological investigation of secretory otitis media in children with cleft palate; Jousimies-Somer H et al.; Altogether 92 middle ear effusion samples from 89 children with cleft (lip) palate and secretory otitis media aged from two months to 15 years were cultured and analyzed bacteriologically . Known middle ear pathogens were isolated from 49 (53%), these accounted for 68% of all positive cultures . The frequency of occurrence of middle ear pathogens was significantly higher in the age group younger than 36 months . The most common bacteria found were S . pneumoniae, B . catarrhalis and H . influenzae . The only anaerobe was a strain of B . fragilis . We believe that by defining culture methods, more pathogens can be isolated from the middle ear of cleft children than has previously been reported . Pathogenic bacteria seem to be found with a higher frequency in children with cleft palate, when compared to normal children.

Drugs, 1986, 31 Suppl 3, 97 - 102
Direct and indirect pathogenicity of Branhamella catarrhalis; Brook I; Branhamella catarrhalis has been recovered from various sites of infection in the respiratory tract . These include chronic otitis media, tonsillitis, adenoiditis and pneumonia . This organism was recovered in many of these infections mixed with other aerobic, facultative anaerobic and anaerobic bacteria . Increasing numbers of isolates of this organism have been noted to produce beta-lactamase . This may contribute to the high failure rate of penicillins in eradicating polymicrobial respiratory infections.

J Am Vet Med Assoc, 1986 Jan 1, 188(1), 46 - 8
Susceptibility of obligate anaerobes to trimethoprim-sulfamethoxazole; Indiveri MC et al.; Susceptibilities of trimethoprim and sulfamethoxazole were tested alone and in combination (1:20) against 94 isolants of obligate anaerobes from clinical specimens . Ninety percent of the isolants were inhibited by less than 0.25 microgram - less than 4.75 micrograms trimethoprim-sulfamethoxazole/ml; 5.4 micrograms trimethoprim/ml and; 900 micrograms sulfamethoxazole/ml . We concluded that trimethoprim-sulfamethoxazole would be effective in the treatment of infectious processes containing species of obligate anaerobes, including those resistant to the penicillin and cephalothin groups of antibiotics.

Acta Chir Scand Suppl, 1986, 530, 51 - 7
Perforating appendicitis . A nine-year survey of treatment and results; Pieper R et al.; This is a clinical study of 193 adult cases of perforating appendicitis during a nine-year period of treatment . There were 77 females (39.9%) and 116 males (60.1%) with ages of 15 years and above . Throughout the study period, the yearly perforation frequency ranged from 10.0 to 23.1% (mean 16.7%) of all cases with proven appendicitis . Perforation was equally common in both sexes, females: 15.5%, males: 17.6% of the appendicitis cases . In elderly patients (greater than or equal to 60 years of age) perforation was much more common; 37 out of 77 cases with proven appendicitis (48.1%) . Compared to different ages (patients under and above 60 years of age), clinical and laboratory findings were found equal . Duration of symptoms showed no differences for younger and elderly patients . Preoperative delay in the hospital of at least 6 hours occurred in 39.9% of all patients, and was found equally common in patients younger than 60 years (39.1%) and in those from 60 years and older (43.2%) . There were no fatalities in the study group . Postoperative septical complications predominated over non-septical (32.6 versus 9.3%), and were equally common in both sexes and in patients of different ages . The frequency of occurrence of septical complications was not significantly influenced by the duration of symptoms or by the duration of operation, furthermore, septical complications were equally frequent throughout the study period, although the use of antibiotics changed towards drugs more potent to cover anaerobic bacteria (28.1% infections for the period 1972-1976 versus 29.8% for the period 1977-1981).(ABSTRACT TRUNCATED AT 250 WORDS)

Eur Surg Res, 1986, 18(5), 331 - 6
Clinical studies of 4 methods of bowel preparation in colorectal surgery; Debo Adeyemi S et al.; A prospective study was carried out to compare the effectiveness of 4 commonly employed methods of bowel preparation before colorectal surgery: mechanical, mechanical with an antibiotic against aerobes (neomycin), mechanical with another antibiotic against anaerobes (metronidazole), and finally mechanical with a combination of neomycin and metronidazole . The use of mechanical preparation as the sole method was discontinued half-way through the study for ethical reasons . 53 bowel preparations were carried out on 31 patients, 7 adults and 24 children with mainly Hirschsprung's disease and imperforate anus . The incidence of postoperative infections ranged from 40 to 46% in the first 3 groups, in contrast to only 6% in the fourth group (p less than 0.05) . The majority of the organisms isolated were gram-negative bacteria . The results show that a combination of mechanical bowel washout with oral neomycin and metronidazole is a most effective method of bowel preparation before colorectal surgery.

Scand J Infect Dis, 1986, 18(6), 503 - 10
Evidence of tinidazole interference in the oropharyngeal inflammatory process during infectious mononucleosis; Marklund G et al.; The efficacy of tinidazole was studied in 24 patients with infectious mononucleosis (IM), 13 of whom were randomized for 5 days of tinidazole treatment and 11 for control without placebo . In judging the comparability of the 2 groups not only was the distribution of confounding factors such as age, sex or duration of symptoms before admission considered, but also the distribution of the Epstein-Barr virus (EBV) serological stage at entry . In these respects the groups were well matched . The duration of sore throat and pharyngotonsillitis after admission was significantly shorter for the patients treated with tinidazole than for the controls . Orosomucoid and lactodehydrogenase concentrations normalized more readily in IM patients with a short duration of sore throat after admission and in patients treated with tinidazole compared to those with a long duration of sore throat and to the tinidazole controls . Clinical and laboratory findings were thus parallel and showed a clinical effect of tinidazole, believed to be mediated via the well-known activity of this drug against anaerobic bacteria . The EBV serological stage of each patient at entry could not predict the duration of symptoms . The results showed that the course of the angina was not primarily dependent on the virus host interaction but probably on other factors, still unknown . One such factor could be the balance between the mucosal defence and the normal oropharyngeal microflora.

Pediatr Infect Dis, 1986 Jan-Feb, 5(1), 120 - 3
Microbiological aspects of erythromycin; Preston DA; Almost 35 years after its discovery, erythromycin remains highly active against most strains of a broad array of clinically important organisms . Many strains of Gram-positive and Gram-negative aerobic, facultative and anaerobic bacteria, as well as Mycoplasma, treponemes and Chlamydia, are susceptible to this agent . Erythromycin acts by binding to the ribosomes of the target organisms, thereby inhibiting protein synthesis . Although a pharmacokinetically superior erythromycin estolate has been shown to be a less potent antibiotic prior to hydrolysis, it appears to contribute significantly to the therapeutic response following administration of erythromycin estolate . Clinical laboratory susceptibility testing or erythromycin may be done using standardized methods, but the laboratorian is cautioned to remember the adverse effect of acidic test conditions on the apparent activity of this antibiotic.

Eur J Clin Pharmacol, 1986, 31(4), 501 - 4
Pharmacokinetics of teicoplanin in patients on continuous ambulatory peritoneal dialysis; Traina GL et al.; We have studied the pharmacokinetics of teicoplanin, a new glycopeptide antibiotic active against Gram-positive aerobic and anaerobic bacteria, in five patients with end-stage renal disease on continuous ambulatory peritoneal dialysis (CAPD) . Although teicoplanin was eliminated in the peritoneal fluid, relatively little was recovered (6.8 +/- 1.2% of the given dose) . The following values were obtained: elimination half-time 102-347 h; total body clearance 4.16-7.38 ml X h-1 X kg-1, peritoneal clearance 0.31-0.37 ml X h-1 X kg-1 . Because the elimination of teicoplanin is about four times less in patients undergoing CAPD compared with subjects with normal renal function, the dose of teicoplanin should be reduced appropriately in such cases.

Dermatol Clin, 1986 Jan, 4(1), 127 - 36
Acne vulgaris in childhood . Pathogenesis and management; Yonkosky DM et al.; Acne vulgaris is a common skin disorder . Although it is most prevalent in the second decade of life, its beginnings are heralded by increased activity of the sebaceous glands and faulty follicular keratinization, which are already evident in mid to late childhood . The subsequent and increasing proliferation of the follicular anaerobic diphtheroid microflora contribute further as an important pathogenic factor in the generation of inflammatory lesions . Treatments of acne, therefore, are aimed at reducing the follicular anaerobic bacteria, counteracting the follicular hyperkeratosis, and inhibiting the activity of sebaceous glands.

Intensive Care Med, 1986, 12(3), 127 - 33
Metabolic arrest; Hochachka PW; In hypoxia sensitive cells and tissues, the rates of glucose and O2 consumption are inversely related (Pasteur Effect) . Under O2 limiting conditions the demands for glucose (glycogen) in such cells may drastically rise as a means for maintaining ATP turnover close to normoxic rates; nevertheless ion and electrical potentials cannot be sustained due to energy insufficiency and high membrane permeability; metabolic and membrane functions, in effect, are decoupled . 'Good' animal anaerobes resolve these problems with a number of biochemical and physiological mechanisms; of these metabolic arrest and stabilized membrane functions are the most effective strategies for extending hypoxia tolerance . Metabolic arrest is achievable by means of a reversed or negative Pasteur Effect (reduced or unchanging glycolytic flux at reduced O2 availability) while coupling of metabolic and membrane function is achievable in spite of the lower energy turnover rates by maintaining membranes of low permeability (probably via reduced densities of ion-specific channels) . Although the strategy of combining metabolic arrest with channel arrest has been recognized as a possible intervention, to date success has been minimal, mainly because cold depression of metabolism is the usual arrest mechanism used and this hypothermia in itself perturbs controlled cell function in most endotherms . The only endothermic systems currently known which appear able to use the dual strategy for extending hypoxia tolerance are hypoperfused hypometabolic tissues and organs of diving marine mammals.

Reprod Nutr Dev, 1986, 26(1B), 129 - 45
{Growth yield and active biomass in anaerobic biotopes}; Belaich JP; The molecular growth yield of anaerobic bacteria has been examined in different growth conditions . The influence of kinetics on energy coupling has been discussed.

Laryngol Rhinol Otol (Stuttg), 1985 Dec, 64(12), 649 - 51
{Metronidazole pharmacokinetics in perilymph, aqueous humor and cerebrospinal fluid}; Koch A et al.; Since metronidazole is very effective against anaerobic bacteria, we studied its pharmacokinetics in perilymph, cerebrospinal fluid, aqueous humour, and serum . 1, 2, 4, 6, 10 and 16.5 hours after intraperitoneal injection of 200 mg/kg metronidazole to six groups of six guinea pigs each, we determined the drug concentrations by high-pressure liquid chromatography . In the serum, 1, 2 and 16.5 hours after application, drug levels of 194 +/- 22 mg/l, 127 +/- 54 mg/l and 2 +/- 1 mg/l respectively were found . Half-life was 6 hours . Similar high and long-lasting concentrations could be determined in the aqueous humour, cerebrospinal fluid and perilymph . In contrast to our findings with aminoglycoside antibiotics, beta lactam antibiotics and fosfomycin, we could not observe any retention of metronidazole in the perilymph.

Am J Vet Res, 1985 Dec, 46(12), 2562 - 5
Bacterial isolates from tracheobronchial aspirates of healthy horses; Sweeney CR et al.; Of tracheobronchial aspirates from 50 clinically healthy Thoroughbred racehorses, 4 (8%) had aerobic bacteria with recognized pathogenicity, 12 (24%) contained transient bacterial isolates, and 37 (74%) had no bacterial growth . Of tracheobronchial aspirates from 36 pastured, nonracing racehorses, 3 (8%) had bacteria with recognized pathogenicity, 23 (64%) contained transient bacteria, and 10 (28%) had no bacterial growth . Anaerobes were not isolated from 12 of 12 pastured horses . Transient bacteria were isolated more often in the pastured horses.

Obstet Gynecol, 1985 Dec, 66(6), 825 - 8
Fusobacterium: anaerobic occult amnionitis and premature labor; Easterling TR et al.; Fusobacterium species are well established pathogens . Before the advent of effective anaerobic antimicrobial therapy, they were associated with prolonged, often fatal courses . Previously, fusobacterium had not been identified as a common perinatal pathogen . Three cases of occult amnionitis due to Fusobacterium are presented . Review of five series of occult amnionitis revealed 23 cases . In seven (30.4%), Fusobacterium was isolated . In 14 (60.8%), an anaerobic species was isolated . The average gestational age of patients from whom anaerobes were grown was 29.0 weeks . Of those that grew no anaerobes, the average gestational age was 32.3 weeks (P less than .05) . The overall rate of maternal febrile morbidity was 35% . Fusobacterium accounted for 50% of the febrile cases while accounting for only 30.4% of the total cases.

Otolaryngol Head Neck Surg, 1985 Dec, 93(6), 743 - 7
Ineffectiveness of closed suction drainage cultures in the prediction of bacteriologic findings in wound infections in patients undergoing contaminated head and neck cancer surgery; Becker GD; Despite the use of perioperative antibiotics, wound infection remains a major source of morbidity after contaminated head and neck cancer surgery . Accurate preoperative indentification of the patient likely to develop wound infection or prediction of the pathogenic organisms would allow a rational approach to antibiotic prophylaxis or initiation of therapy at the first sign of infection . This prospective study of patients undergoing contaminated head and neck cancer surgery evaluated cultures from hemovac lines in the prediction of the patient at high risk for wound infection and the bacteriologic findings in subsequent wound infections . Cultures were obtained from aspirates of the hemovac lines in 30 patients; 13% (four of 30 patients) developed a wound infection . Aerobic isolates were recovered in 100% (30 of 30 patients) . Pathogens were isolated from 75% (three of four) and 73% (19 of 26) of patients with and without infection, respectively . Anaerobic bacteria were recovered in 8% (two of 26) of patients . There was a correlation between hemovac isolates and the patient's subsequent recovery from the wound infection in 50% (two of four) of the infected wounds . Cultures of hemovac lines in patients undergoing contaminated head and neck cancer surgery were not predictive of the high-risk patient or the bacteriologic findings in subsequent wound infections.

J Oral Maxillofac Surg, 1985 Dec, 43(12), 971 - 3
Closed percutaneous catheter drainage of a cervical abscess; Sacks JC et al.; The advantages offered by a percutaneous catheter system are: The procedure is done using only local anesthesia . Computed tomography is used for exquisite anatomical detail and pinpoint guidance . If required, aspiration, irrigation, and dependent or suction drainage can all be done . Isolation of purulent material from the skin and site of drainage is accomplished . A true anaerobic culture specimen is obtainable with the initial aspiration . The esthetic results, are superior to surgical management . Percutaneous abscess drainage should thus be seriously considered as an alternative to surgery in the treatment of head and neck abscesses.

Appl Environ Microbiol, 1985 Dec, 50(6), 1451 - 6
Anaerobic degradation of veratrylglycerol-beta-guaiacyl ether and guaiacoxyacetic acid by mixed rumen bacteria; Chen W et al.; Veratrylglycerol-beta-guaiacyl ether (0.2 g/liter), a lignin model compound, was found to be degraded by mixed rumen bacteria in a yeast extract medium under strictly anaerobic conditions to the extent of 19% within 24 h . Guaiacoxyacetic acid, 2-(o-methoxyphenoxy)ethanol, vanillic acid, and vanillin were detected as degradation products of veratrylglycerol-beta-guaiacyl ether by thin-layer chromatography, gas chromatography, and gas chromatography-mass spectrometry . Guaiacoxyacetic acid (0.25 g/liter), when added into the medium as a substrate, was entirely degraded within 36 h, resulting in the formation of phenoxyacetic acid, guaiacol, and phenol . These results suggest that the beta-arylether bond, an important intermonomer linkage in lignin, can be cleaved completely by these rumen anaerobes.

Jpn J Antibiot, 1985 Dec, 38(12), 3666 - 73
{Study on transfer of aztreonam into female genital organs}; Hongo M et al.; Aztreonam (AZT) is a newly developed beta-lactam antibiotic for use of intravenous injection . It is the first drug in the world of monobactam series with the structural characteristic of monocyclic beta-lactam . The antimicrobial spectrum of AZT is unique, having little or no susceptibility against Gram-positive organisms and anaerobes, but showing high susceptibility against aerobic Gram-negative rods including Pseudomonas . One gram of AZT was given intravenously to 32 patients prior to abdominal total hysterectomy for uterine myoma . Bilateral uterine arteries were clamped at 0.25, 0.5, 1, 2, 4, 8 or 12 hours after administration, and serum samples and uterine tissues were taken for the measurement of AZT concentration by bioassay method . Little difference was found in the serum concentration between cubital venous and uterine arterial serum, the half-lives of both being 2.11 hours . The initial concentrations were estimated to be 68.0 micrograms/ml and 63.9 micrograms/ml, respectively . While the peak concentrations of the portio vaginalis, cervix uteri, myometrium and oviduct were obtained at about 10 minutes, those of the endometrium and ovary were at 18.2 minutes and 31.3 minutes, respectively . They were as follows; the portio vaginalis 50.0 micrograms/g, the cervix uteri 43.6 micrograms/g, the myometrium 29.8 micrograms/g, the oviduct 44.7 micrograms/g, the endometrium 27.3 micrograms/g, the ovary 29.0 micrograms/g . After showing peak, tissue levels were kept fairly high up to 3 hours, then decreased gradually as time passed up to approximately 8 hours . Judging from its favorable transfer into the uterine tissues and MICs against main clinical isolates in the field of obstetrics and gynecology, AZT is evaluated to be clinically useful in the treatment of obstetrical and gynecological infections.

Jpn J Antibiot, 1985 Dec, 38(12), 3629 - 33
{In vitro activity and clinical evaluation of aztreonam in the field of obstetrics and gynecology}; Ninomiya K et al.; Antimicrobial activity of aztreonam (AZT) against 231 clinical isolates in the field of obstetrics and gynecology was determined by agar-plates dilution method . Almost of all strains of E . coli (108 strains) tested were susceptible to the concentration of 0.20 micrograms/ml of AZT . Anaerobic bacteria, however, were less susceptible to this antibiotic than to cefazolin . The concentrations of AZT were determined in serum and pelvic tissue samples obtained at various intervals after 1 hour intravenous drip infusion with 1 g . The concentrations of AZT in pelvic tissues were maximal 9.3 micrograms/g at 57 minutes but less than 0.6 micrograms/g at 3 hours or more after injection . Clinical efficacy of AZT was evaluated in 6 cases consisted of two each with Bartholin's abscess and intrauterine infection and one each with post partum endometritis and acute adnexitis . Clinical efficacies were seen in 5 cases.

Jpn J Antibiot, 1985 Dec, 38(12), 3520 - 6
{Preclinical and clinical studies on aztreonam in obstetrics and gynecology}; Seki H et al.; Aztreonam (AZT), a new monobactam antibiotic, was studied in obstetrics and gynecology with the following results . The tissue concentration of AZT in the female genital organs was relatively high at the portio vaginalis and the cervix uteri followed by at the ovary and the myometrium, but the distribution to the endometrium and the oviduct was a little poor . The concentration of AZT in the pelvic dead space exudate was highest at 2 hours after intravenous injection whereas it was highest at 5 hours after intravenous drip infusion . However, there was no significant difference in the concentration between intravenous injection and intravenous drip infusion and the distribution to the pelvic dead space exudate was relatively good . AZT was clinically administered to pyometra (3 cases), puerperal endometritis (3), adnexitis and endometritis (3), pelvioperitonitis (1), Bartholin's abscess (4) and purulent vulvitis (1), a total of 15 cases with an overall effective rate of 93.3% . AZT was microbiologically effective for Gram-negative bacteria such as E . coli and K . pneumoniae, but also effective for anaerobes and some Gram-positive bacteria, etc., for which MIC of AZT is high . With regard to safety of AZT, neither side effects nor abnormal laboratory findings were reported.

Environ Health Perspect, 1985 Dec, 64, 309 - 20
Some reactions and properties of nitro radical-anions important in biology and medicine; Wardman P; Nitroaromatic compounds, ArNO2 have widespread actual or potential use in medicine and cancer therapy . There is direct proof that free-radical metabolites are involved in many applications, and an appreciation of the conceptual basis for their therapeutic differential; however, an understanding of the detailed mechanisms involved is lacking . Redox properties control most biological responses of nitro compounds, and the characteristics of the one-electron couple: ArNO2/ArNO2- are detailed . The "futile metabolism" of nitroaryl compounds characteristic of most aerobic nitroreductase systems reflects competition between natural radical-decay pathways and a one-electron transfer reaction to yield superoxide ion, O2- . Prototropic properties control the rate of radical decay, and redox properties control the rate of electron transfer to O2 or other acceptors . There are clear parallels in the chemistry of ArNO2- and O2- . While nitro radicals have frequently been invoked as damaging species, they are very unreactive (except as simple reductants) . It seems likely that reductive metabolism of nitroaryl compounds, although generally involving nitro radical-anions as obligate intermediates (and this is required for therapeutic selectivity towards anaerobes), results in biological damage via reductive metabolites of higher reduction order than the one-electron product.

Am J Med, 1985 Nov 29, 79(5B), 33 - 8
In vitro activity and in vivo evaluation of ticarcillin plus clavulanic acid against aerobic and anaerobic bacteria; Bansal MB et al.; The efficacy of ticarcillin plus clavulanic acid was compared with that of certain broad-spectrum antibiotics such as ticarcillin, azlocillin, and piperacillin against blood culture isolates of aerobic bacteria obtained from seriously ill patients and anaerobic bacteria obtained from other miscellaneous infections . Ticarcillin plus clavulanic acid was found to be as effective as other broad-spectrum antibiotics against most of the 285 septicemic isolates tested . Ticarcillin plus clavulanic acid was most effective against 351 anaerobic bacteria, including B . fragilis . Further, 32 strains of B . fragilis that were relatively resistant to ticarcillin and azlocillin were tested with a mixture of ticarcillin or azlocillin, each in combination with clavulanic acid . Ticarcillin plus clavulanic acid inhibited all 32 strains of B . fragilis . Addition of clavulanic acid to cephalothin, penicillin, or azlocillin also augmented the antibiotic activity against B . fragilis by 4- to 64-fold . These in vitro data suggest that ticarcillin plus clavulanic acid may be used as a single antibiotic in the cases of bacterial septicemias and that the combination may be used in the treatment of multiple-antibiotic-resistant bacterial strains . In a related study, the augmentation activity of clavulanic acid with penicillin or ticarcillin was evaluated against B . fragilis in a rat intra-abdominal abscess model . Gelatin capsules filled with a mixture of B . fragilis and Escherichia coli were implanted intraperitoneally in male Wistar rats . Four different groups of animals with appropriate controls were treated with penicillin or ticarcillin alone or in combination with clavulanic acid . Treatment was started immediately or delayed for 48 hours after peritoneal soilage . The mortality rate decreased by almost one half when antibiotic therapy was started immediately . Treatment with ticarcillin plus clavulanic acid resulted in a cure in 70 to 89 percent of animals, showing that this combination is the most effective regimen in the treatment of rats with experimental intra-abdominal abscesses caused by B . fragilis and E . coli.

Cutis, 1985 Nov 15, 36(5A), 21 - 4
Treatment of wound infections; Klimek JJ; Postoperative wound infections and infections linked to various traumatic and thermal injuries all contribute to patient morbidity and mortality, as well as to increased hospital costs . Standard practices of wound management include debridement of devitalized tissue, drainage, irrigation, and loose packing of the open wound . Antibiotics are usually effective as adjuncts to these procedures and to host resistance . Their choice, whenever possible, should be based on cultures of fresh pus (anaerobes must be obtained by airless syringe) to select an agent active against implicated pathogens . In rapidly developing infections, the choice must often be based on known probabilities until culture results are available . Specific management techniques are indicated for postoperative wounds, where brief prophylactic treatment may be needed . Traumatic wounds may require combination antibiotic therapy, and possible lack of immunity to tetanus should be considered . Most burn wound infections tend to be nosocomial; topical antiseptic agents often control burn infections while preventing the emergence of resistant bacteria.

Dtsch Med Wochenschr, 1985 Nov 8, 110(45), 1724 - 30
{Metronidazole in the treatment of Crohn disease . Results of a controlled randomized prospective study}; Schneider MU et al.; In a controlled, randomised prospective study on 52 patients with active ileocolitis Crohn (n = 44) or discharging fistulae (n = 18) metronidazole monotherapy was compared with a combination of cortisone and salazosulfapyridine, and of cortisone, salazosulfapyridine and metronidazole, respectively . Therapeutic efficacy was judged by various clinical, laboratory and haematological activity parameters, as well as by closure of discharging fistulae . Although analysis of variance showed no significant differences in the changes in individual activity parameters between the three groups, the combination of cortisone, salazosulfapyridine und metronidazole normalised the nine activity parameters more often than the other treatments . Metronidazole alone led to complete closure of discharging fistulae in 40% of cases and produced a clear reduction in fistula discharge in a further 20% . A more effective fistulae therapy could not be achieved even when combined with cortisone and salazosulfapyridine . In view of the dose-related serum concentrations of metronidazole and its minimal inhibitory concentration for anaerobic bacteria, the dose of metronidazole in ileocolitis Crohn should not be less than 400 mg/d . After evaluation of all findings, and taking into account the neurological side effects of long-term metronidazole therapy, the main indications for metronidazole in ileocolitis are failure of cortisone and salazosulfapyridine as well as discharging fistulae.

Antibiot Med Biotekhnol, 1985 Nov, 30(11), 850 - 5
{Rapid methods in culturing nonsporulating anaerobes and determining their antibiotic sensitivity by using disks}; Baltrashevich AK et al.; A review of methods for determination of sensitivity of nonsporulating anaerobic bacteria to antibacterial drugs with paper disks is presented and the prospects for using the method of cultivation in solid media in Petri dishes under a polymer film are discussed . It is shown that cultivation at a temperature of 42 degrees C for obtaining earlier results instead of the temperature of 37 degrees C usually used for cultivation has no advantages . With an account of the result variability depending on the inoculation dose and other factors it is necessary to determine the boundary values of the growth inhibition zones for resistant, moderate sensitive and sensitive strains with respect to every antibiotic.

Antibiot Med Biotekhnol, 1985 Nov, 30(11), 847 - 9
{Current methods of determining the sensitivity to antibacterial preparations of anaerobic microorganisms}; Dronova OM et al.; Antibacterial therapy of infections caused by anaerobic bacteria requires consideration of the data on periodical estimation of sensitivity of the main groups of pathogens to antibacterial drugs . The method of serial dilutions in solid nutrient media is the most accurate and handy for estimation of sensitivity of a large number of strains of anaerobic bacteria . The method of elution of a drug from a paper disk into the liquid thioglycol medium is the most applicable for determination of sensitivity of anaerobic pathogens in specific cases in customary laboratories.

Acta Chir Belg, 1985 Nov-Dec, 85(6), 349 - 53
24-hour systemic antimicrobial prophylaxis with gentamicin and metronidazole, or metronidazole alone, in elective colorectal surgery after mechanical bowel preparation with mannitol and whole gut irrigation; Weidema WF et al.; In a prospective randomized trial, systemic antimicrobial prophylaxis with metronidazole and gentamicin was compared to the administration of metronidazole alone in elective colorectal surgery . In both groups, an identical mechanical large-bowel preparation was performed . In order to reduce the duration of the whole-gut irrigation, a 10% mannitol solution was administered before the irrigation procedure . Although no serious infections were observed in either group, the incidence of superficial wound infections was relatively high: 19% in the group with metronidazole and gentamicin prophylaxis and 25% in the other group . From all these wounds E . coli was isolated, and no obligate anaerobic bacteria were cultured . This high rate of wound infections is most likely caused by an overgrowth of E . coli after irrigation, due to the residues of mannitol in the colon, which serve as a nutrient for E . coli . It is concluded that mannitol should not be used in the preoperative mechanical preparation of the large bowel before elective colorectal surgery.

Rev Infect Dis, 1985 Nov-Dec, 7 Suppl 4, S679 - 89
Current problems in antibiotic treatment in obstetrics and gynecology; Ledger WJ; PIP: More sophisticated knowledge of the microbiologic components of pelvic infection, the availability of several new antimicrobial agents, and pressures to control medical costs are contributing to changes in antibiotic prescribing patterns in hospitals in the US . The use of prophylactic antibiotics is the area that has undergone the greatest change in the field of obstetrics and gynecology . Prophylactic antibiotics are widely administered after cesarean section to prevent postpartum soft tissue infections . The combination of clindamycin and an aminoglycoside, or single-agent therapy with a newer cephalosporin or penicillin, results in a higher success rate than the previous regimen of penicillin G and an aminoglycoside . Women given prophylactic antibiotics in conjunction with vaginal hysterectomy also demonstrate a reduced incidence of postoperative uterine infections; in abdominal hysterectomy, the utility of this approach is not as obvious . For patients with pelvic infections, those with early infection (symptoms for 4 days or less and no indurated mass) are more likely to be cured by antibiotics and less likely to require operative intervention than those with more advanced infection . The selection of antibiotic in cases of pelvic infection should be based on the susceptibility patterns of the organism and the antibiotic's ability to reduce high counts of anaerobic bacteria . Both metronidazole and clindamycin meet these criteria .

Rev Infect Dis, 1985 Nov-Dec, 7 Suppl 4, S734 - 40
Overview of empiric antibiotic therapy for the febrile neutropenic patient; Schimpff SC; The febrile neutropenic patient with cancer requires the prompt administration of empirically chosen antibiotic therapy . For many years the choice has usually been an aminoglycoside plus either a cephalosporin or an antipseudomonal penicillin; the exact combination was dependent on local patterns of infection and especially on local patterns of microbial resistance . In the absence of resistance problems, one normally would choose the least expensive aminoglycoside and, probably, the least expensive antipseudomonal penicillin . A new approach to be considered is the use of single agents with very broad spectra such as ceftazidime or imipenem . However, such an approach is fraught with danger--that of leaving a resistant pathogen "uncovered" and of eliminating the possible benefits of synergistic activity against bacteremia due to gram-negative organisms in the profoundly neutropenic patient . Combinations of two beta-lactam agents have the advantage of not being nephro- or ototoxic, although with a few such combinations antagonism has been demonstrated . A final approach is the use of regimens that include aztreonam, ceftazidime, or imipenem, which have little or no suppressive effect on stool anaerobes . Presumably, with these agents colonization resistance will be preserved and the opportunities for secondary infection with a resistant organism will be reduced.

J Clin Microbiol, 1985 Nov, 22(5), 882 - 3
Cefoperazone and cefoperazone-sulbactam susceptibility tests with anaerobic bacteria by the thioglycolate disk elution method; Barry AL et al.; Tests were performed with 104 anaerobic microorganisms to evaluate the thioglycolate disk elution technique for the detection of resistance to cefoperazone and cefoperazone-sulbactam . An unacceptably high false-resistance rate and a poor reproducibility record make the disk elution procedure unsatisfactory for routine testing of this drug or combination of drugs.

Scand J Gastroenterol, 1985 Oct, 20(8), 945 - 50
Comparative pharmacokinetics of metronidazole and tinidazole and their tissue penetration; Bergan T et al.; Since metronidazole and tinidazole are used prophylactically against infections after colorectal surgery, their pharmacokinetics and that of hydroxy-metronidazole were compared in 34 such patients . Seventeen patients received a single dose of 1.5 g (50-min infusion) of either agent 1 h before the operation . The concentrations of serum and tissue homogenates (subcutaneous fat, omentum, peritoneum, ileum, appendix, colon) were assayed by high-pressure liquid chromatography . The serum concentrations 1 h after start of infusion were 34.1 +/- 6.7 mg/l of metronidazole, 2.3 +/- 1.2 mg/l of OH-metronidazole, and 35.2 +/- 6.3 mg/l of tinidazole . OH-metronidazole and tinidazole were detectable for 72 h and metronidazole for 48 h . The ranges of serum and tissue concentrations (subcutaneous fat, omentum, peritoneum, ileum, appendix, colon) overlapped (within one single standard deviation) . The tissue concentrations were high, particularly in intestinal tissues, except that the levels were low in subcutaneous tissue . The serum half-life of metronidazole was 9.0 +/- 1.6 h, of OH-metronidazole 14.8 +/- 7.4 h, and of tinidazole 16.4 +/- 3.8 h . The terminal-phase distribution volume was 35.8 +/- 10.01 for metronidazole and 40.6 +/- 9.91 for tinidazole, and the total body clearance 2.7 +/- 1.2 l/h and 1.8 +/- 0.5 l/h, respectively . The slower disposition of OH-metronidazole, which inhibits anaerobic bacteria, prolongs the duration of bioactivity in the body after metronidazole to that reached by tinidazole . OH-tinidazole was not detected in patient specimens (assay standards ensured that it could be assayed).(ABSTRACT TRUNCATED AT 250 WORDS)

Can J Comp Med, 1985 Oct, 49(4), 384 - 90
Ultrastructural characterization of colonic lesions in pigs inoculated with Treponema hyodysenteriae; Albassam MA et al.; Twelve pigs were inoculated orally with pure cultures of Treponema hyodysenteriae . Pigs were necropsied at different time intervals postinoculation; colonic specimens were collected and prepared for light and electron microscopy . The earliest colonic lesion detected by electron microscopy consisted of superficial vascular congestion and dilatation, edema of the lamina propria and intercellular separation of the epithelial cells at the crypt shoulders . This lesion progressed to epithelial cell necrosis and extrusion into the lumen and extravasation of red cells . Large numbers of spirochetes were present and free, between, over and under necrotic epithelial cells whether in place or partially extruded . Spirochetal penetration of colonic enterocytes and intracytoplasmic multiplication were confirmed in this study . The spirochetes were found to invade the epithelial cells only from their lateral borders . The relationship between T . hyodysenteriae and the colonic anaerobes was not determined.

J Bacteriol, 1985 Oct, 164(1), 316 - 20
Oxidation of protoporphyrinogen in the obligate anaerobe Desulfovibrio gigas; Klemm DJ et al.; The anaerobic oxidation of protoporphyrinogen to protoporphyrin was demonstrated in extracts of Desulfovibrio gigas . Protoporphyrin formation occurred in the presence of nitrite, hydroxylamine, sulfite, thiosulfate, ATP plus sulfate, NAD+, NADP+, flavin adenine dinucleotide, flavin mononucleotide, fumarate, 2,6-dichlorophenol-indophenol, methyl viologen, and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide . With dialyzed cell extracts, highest activities were observed with sulfite, NAD+, and NADP+ as electron acceptors . The enzyme for protoporphyrinogen oxidation was localized in the membrane of D . gigas and displayed optimal activity at pH 7.3 and 28 degrees C.

J Gen Microbiol, 1985 Oct, 131 ( Pt 10), 2573 - 9
Respiration rate, growth rate and the accumulation of streptomycin in Escherichia coli; Muir ME et al.; Using chemostat cultures of Escherichia coli it was possible to vary respiration rates while maintaining a constant growth rate . This allowed the effect of variations in respiration rates on the accumulation of streptomycin to be studied in cultures at constant growth rates . At a particular dilution rate cultures exhibited higher respiration rates when phosphate limited growth than when carbon limited growth . A ubiquinone-deficient strain had a lower rate of respiration at a particular dilution rate than a related ubiquinone-sufficient strain . In spite of these differences in respiratory activity, the accumulation of streptomycin was identical in carbon- and in phosphate-limited chemostat cultures of ubiquinone-deficient and ubiquinone-sufficient strains . Moreover, accumulation of streptomycin in an anaerobic chemostat culture occurred at the same rate as that in an aerobic chemostat . There was however a lag of 1.5 h before accumulation commenced in the anaerobic culture, a feature that was not apparent in the aerobic culture . These results indicate that the lower rates of respiration in slow-growing bacteria are not responsible for the decreased accumulation of streptomycin in slow-growing compared to fast-growing cultures . Moreover, it seems unlikely that quinones are involved directly (e.g . as carriers) in streptomycin accumulation, since removal of 90% of cellular ubiquinone, or replacement of ubiquinone with a structural analogue, did not affect accumulation as long as mutant and parent cultures grew at the same rate.

Am J Reprod Immunol Microbiol, 1985 Sep, 9(1), 1 - 5
Qualitative and quantitative changes of the vaginal microbial flora during the menstrual cycle; Johnson SR et al.; Knowledge of the normal vaginal microbial flora is essential in understanding the etiology of female genital tract infections . This study was done to investigate both qualitative and quantitative differences that occur during the menstrual cycle . We studied 34 reproductive age women longitudinally . Quantitative cultures were obtained during menses and following the cessation of menses . A greater variety of organisms were found during menstruation . The effect was not selective with respect to aerobes or anaerobes . The total number of bacteria between the two culture periods did not change significantly.

J Chromatogr Sci, 1985 Sep, 23(9), 385 - 90
Capillary gas chromatographic analysis of volatile and non-volatile organic acids from biological samples as the t-butyldimethylsilyl derivatives; Schooley DL et al.; A quantitative procedure for the analysis of volatile organic acids and lactic acid in silage is described . The samples were extracted with diethyl ether, derivatized by t-butyldimethylsilylation, and then separated by capillary gas chromatography . The same procedure was useful for the identification by gas chromatography/mass spectrometry of organic acids in samples such as the metabolic fermentation products of anaerobic bacteria.

Pediatr Med Chir, 1985 Sep-Oct, 7(5), 761 - 3
{Effectiveness of piperacillin in childhood infections}; Biella CA et al.; Piperacillin is a semisynthetic penicillin with a broad-spectrum: in particular it is active against Gram positive, Gram negative, aerobic and anaerobic bacteria often resistant to other antibiotics of the same group . We report a trial carried out on 38 children with severe and moderate infections treated with piperacillin . We have considered ESR, all leucocytes count and body temperature . No severe side effects have been reported . Piperacillin must be used as a first choice in pediatric age, mostly in case of mixed bacterial infections and in immunocompromised patients.

J Gen Microbiol, 1985 Aug, 131 ( Pt 8), 2075 - 8
Purification and characterization of flagella from Roseburia cecicola, an obligately anaerobic bacterium; Martin JH et al.; Flagella from Roseburia cecicola, an obligately anaerobic bacterium originally isolated from murine caecal mucosa, were purified by mechanical shearing followed by differential centrifugation . Purity of the flagellar preparation was determined by polyacrylamide gel electrophoresis, electron microscopy and chemical analysis . The flagella were composed of a single protein subunit (flagellin) with an estimated molecular weight of 42 000 . The amino acid composition of the flagellin was similar to that of some facultatively anaerobic and aerobic bacteria.

Anaesth Intensive Care, 1985 Aug, 13(3), 241 - 8
Acute enteric sepsis: bacteriology and antibiotic cover; Steele TW; Most cases of enteric sepsis are caused by both aerobic and anaerobic organisms which form the normal flora of the mouth and lower gastrointestinal tract . This flora is extremely variable and subject to change due to disease and antimicrobial treatment . Bacteriological investigation of patients with severe enteric sepsis is important and should be undertaken before antibiotic treatment is commenced . The choice of antibiotics depends on the nature of the infection and its location . Initially they should be given in maximum dosage . If polymicrobial infection is suspected both aerobes and anaerobes should be covered to prevent bacteraemic shock and abscess formation . If abscesses have formed or the patient fails to respond to appropriate antibiotics, surgical exploration and drainage remain the treatment of choice . Antibiotics often fail to eradicate organisms from established abscesses and are responsible for some serious complications.

Eur J Clin Microbiol, 1985 Aug, 4(4), 404 - 7
Detection of anaerobic bacteria in blood cultures by lysis filtration; Heimdahl A et al.; An anaerobic adaptation of the lysis-filtration system for detection of anaerobic microorganisms in blood is described . The method was compared with a conventional broth bottle system in detection of anaerobic bacteremia after oral surgery . Of 43 blood samples obtained during and after surgery, 31 were positive with the lysis-filtration system and 17 were positive with the broth bottle system . Sixteen aerobic and 62 anaerobic strains were isolated with the lysis-filtration system versus 9 aerobic and 22 anaerobic strains with the broth bottles . The lysis-filtration technique was thus superior to the conventional broth bottle method in detecting anerobic bacteria.

J Clin Microbiol, 1985 Aug, 22(2), 299 - 302
Clinical appearance of orofacial infections of odontogenic origin in relation to microbiological findings; Heimdahl A et al.; Fifty-eight patients with acute orofacial infections of odontogenic origin were classified into two groups with respect to the severity of infection . A total of 174 anaerobic and 22 aerobic bacterial strains were isolated . Anaerobic gram-negative rods were isolated more frequently from the patients with severe infections than from the patients with infections judged as mild (P less than 0.05) . The occurrence of Fusobacterium nucleatum especially appeared to be associated with the severity of the infections (P less than 0.05) . Penicillin resistance among the anaerobes was rarely found, while resistance to erythromycin was a common finding . All aerobic and anaerobic bacteria were susceptible to clindamycin, and all obligate anaerobic bacteria were susceptible to nitroimidazoles.

Br J Surg, 1985 Aug, 72(8), 637 - 40
Pilonidal sinus excision--healing by open granulation; Marks J et al.; A prospective study is reported of 100 pilonidal sinus excisions healing by open granulation . Delays in healing appeared to be due to infection, particularly by anaerobic bacteria . Comparisons are made between three groups studied consecutively - 30 wounds not treated with antibiotics, 20 given a fixed two-week course of metronidazole and 50 managed flexibly . In this last group, wound management was determined by clinical appearance; 24 wounds were clinically healthy throughout and received no antibiotic while 26 looked unhealthy initially or after an interval and were treated with metronidazole, supplemented in some cases with erythromycin . The best results were obtained in the group managed flexibly . It is considered that the problems of delayed healing are due to excisions which leave a wound of a shape ill-designed to maintain good drainage . Unhealthy wounds should be re-shaped if possible and treated early with a combination of metronidazole and erythromycin.

J Clin Pathol, 1985 Aug, 38(8), 933 - 6
Analysis by gas liquid chromatography of production of volatile fatty acids by anaerobic bacteria grown on solid medium; Wiggins RJ et al.; Volatile fatty acids produced in Robertson's cooked meat medium by a range of clinically relevant anaerobes were compared by gas liquid chromatography with those produced in blood agar . The same volatile fatty acid profiles were obtained in both media, although the concentration of acids was lower in blood agar . We conclude that detection of volatile fatty acids from a pure culture of an organism on solid medium is practicable and offers advantages over the conventional technique.

Br J Surg, 1985 Jul, 72(7), 571 - 3
Metronidazole and Augmentin in the prevention of sepsis after appendicectomy; Drumm J et al.; Two hundred and fifty patients were admitted to a prospective randomized trial to compare the efficacy of Augmentin with metronidazole in the prevention of sepsis after appendicectomy . Pre-operatively they received either 500 mg metronidazole or 1.2g Augmentin intravenously . Those patients with gangrenous or perforated appendices received eight additional doses of the trial drug at 8 hourly intervals . Overall there were 13 wound infections in the Augmentin group (11 per cent) and 21 in the metronidazole group (18 per cent) . The 90 per cent confidence limits for the overall 7 per cent difference in infection rates were +/- 8.5 per cent . There were high rates of wound infection in the gangrenous group (Augmentin 8 per cent versus metronidazole 19 per cent) and especially in the perforated group (Augmentin 33 per cent versus metronidazole 63 per cent) . There was no statistically significant difference between the infection rates with the two antibiotics but our study suggests that Augmentin, which is active against both aerobes and anaerobes, may be more effective than metronidazole in reducing wound sepsis after appendicectomy.

Rev Infect Dis, 1985 Jul-Aug, 7 Suppl 3, S528 - 36
Efficacy and safety of imipenem/cilastatin: a review of worldwide clinical experience; Wang C et al.; The clinical experience of 1,723 patients treated with imipenem/cilastatin in worldwide clinical trials is reviewed . Dosages of imipenem administered parenterally with cilastatin varied with the severity of the infection and included 250 mg four times a day; 500 mg three or four times a day, and 1 g three of four times a day . Infections of all body systems except the central nervous system due to gram-positive or gram-negative aerobes and anaerobes as well as those due to mixed organisms were treated . Clinical efficacy was demonstrated in 92% of infections . The adverse clinical and laboratory experiences associated with imipenem/cilastatin were similar to those of other beta-lactam agents and included disturbances of gastrointestinal and central nervous system function, allergic reactions, and transient elevations of liver enzyme levels.

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