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, th