Rev Infect Dis, 1985 Jul-Aug, 7 Suppl 3, S496 - 505 Open trial of imipenem/cilastatin therapy for serious bacterial infections; Brooks RG et al.; Imipenem is a new beta-lactam antibiotic with a wide spectrum of activity against gram-positive and gram-negative aerobic and anaerobic bacteria . The efficacy and toxicity of this drug, when administered parenterally in combination with the dehydropeptidase I inhibitor cilastatin, were studied in 41 hospitalized patients with serious infections . Clinical cure was achieved in 26 (79%) of the 33 patients who could be evaluated and microbiologic cure in 23 (85%) of the 27 patients who could be evaluated . Adverse clinical or laboratory reactions were observed in seven (17%) of the 41 patients . Thus, imipenem/cilastatin was highly effective in the treatment of a wide variety of serious bacterial infections. J Clin Microbiol, 1985 Jul, 22(1), 32 - 5 Comparison of the PRAS II, AN-Ident, and RapID-ANA systems for identification of anaerobic bacteria; Burlage RS et al.; Two rapid systems for the identification of anaerobes were compared to a conventional growth system aided by a computer . The rapid systems (AN-Ident and RapID-ANA) are non-growth-dependent micromethods that identify anaerobes in 4 h by the action of various constitutive enzymes on chromogenic substrates . The organisms tested were 98 anaerobes, most of which were clinical isolates . The AN-Ident system identified 76 of these to species level and 86 to genus level; the RapID-ANA system correctly identified 74 of the organisms to species level and identified 93 to genus level . The PRAS II system correctly identified 77 to species level and 96 to genus level . In most instances, adequate identification could be obtained with either of the two rapid systems, but the conventional PRAS II system remains the most accurate. JPEN J Parenter Enteral Nutr, 1985 Jul-Aug, 9(4), 501 - 3 Metronidazole prevention of serum liver enzyme abnormalities during total parenteral nutrition; Lambert JR et al.; Abnormal serum liver enzymes are common in adults receiving total parenteral nutrition (TPN) . The mechanism(s) responsible for these changes is unclear . One hypothesis is that there is overgrowth of intestinal anaerobic bacteria with subsequent toxic effects on the liver from endotoxins and/or bile acids . A retrospective survey of patients receiving TPN was undertaken . The patients were divided into two matched groups . One group had received metronidazole, a drug that suppresses anaerobic bacteria, while the other group had not . The administration of metronidazole during TPN was associated with prevention of the expected rise of serum alkaline phosphatase, gamma glutamyl transpeptidase, and aspartate amino-transferase . This study supports the concept that anerobic intestinal bacteria may be involved in the pathogenesis of liver changes commonly observed during TPN. Am J Med, 1985 Jun 28, 78(6B), 165 - 9 Patient cost in the treatment of postsurgical female pelvic infection; Faro S; Soft tissue female pelvic infections, that is, postpartum endomyometritis, pelvic cellulitis, and salpingitis, are frequently polymicrobial, involving aerobic and anaerobic bacteria . The most common antibiotic regimen employed for the treatment of these patients is clindamycin and an aminoglycoside . Single-agent therapy, utilizing the newer beta-lactams, is more economical, potentially less toxic, and as effective. Antimicrob Agents Chemother, 1985 Jun, 27(6), 958 - 60 In vitro activity of cefbuperazone and other antimicrobial agents against isolates from the female genital tract; Ohm-Smith MJ et al.; Cefbuperazone (BMY 25182), a new cephamycin, showed activity similar to those of moxalactam and other cephalosporin-cephamycins against aerobic and anaerobic bacteria from female genital tract infections . MICs of the antimicrobial agents were less than or equal to 16 micrograms/ml for greater than 97% of organisms tested . All of the anaerobic bacteria tested were susceptible to clindamycin, metronidazole, and chloramphenicol. Am J Reprod Immunol Microbiol, 1985 Jun, 8(2), 67 - 70 Clindamycin levels in reproductive tissues; Johnson SR et al.; Clindamycin is widely used in a variety of obstetric and gynecologic infections . Despite in vitro and clinical evidence of activity against anaerobes, genital organ tissue levels resulting from intravenous administration of the drug have not previously been reported . Following a single intravenous infusion of 600 mg of clindamycin phosphate, tissue levels were determined in operative specimens obtained from ten women . Specimens of cervix, uterus, fallopian tube, and ovary were obtained, and mean Clindamycin levels for each site were: cervix, 2.63 micrograms/ml; endometrium, 5.58 micrograms/ml; myometrium, 2.39 micrograms/ml; fallopian tube, 2.96 micrograms/ml; and ovary, 3.74 micrograms/ml . The mean serum level was 6.26 micrograms/ml at the time of uterine artery interruption . The clindamycin concentrations at all sites exceeded the usual therapeutic minimal inhibitory concentration, substantiating the usefulness of clindamycin in obstetric and gynecologic anaerobic infections. Eur J Clin Microbiol, 1985 Jun, 4(3), 282 - 5 Comparison of two systems for identification of anaerobic bacteria; Gulletta E et al.; The RapID Ana and the API 20A systems for identification of anaerobic bacteria were compared for accuracy on 108 recent isolates of gram-negative and gram-positive anaerobic bacteria . No additional tests or gas-liquid chromatography were used . RapID Ana identified 91.7% of the isolated strains to species level and 6.5% to genus level but failed to identify 1.8% of the total strains . API 20A identified 85.2% of strains to species level, 3.7% to genus level but failed to identify 11.1% of the total strains . Although the difference between the identification rates of the two systems was not significant, it was concluded that RapID Ana was easier to perform and interpret. J Clin Microbiol, 1985 Jun, 21(6), 894 - 8 Accuracy and reproducibility of a four-hour method for anaerobe identification; Appelbaum PC et al.; In this study, we evaluated the ability of a 4-h enzyme assay kit system, the RapID ANA method (Innovative Diagnostic Systems, Inc., Atlanta, Ga.) to accurately and reproducibly identify a spectrum of clinically significant anaerobic bacteria in two separate institutions . Additional tests were performed as required . Of a total of 188 organisms tested at Hershey Medical Center (HMC), 86.2% were correctly identified to species level without additional tests, 5.9% required extra tests for correct identification, and 8.0% were misidentified . Of 53 strains tested at Johns Hopkins Hospital (JHH), 52.8% were correctly identified without extra tests, 28.3% required extra tests for correct identification, and 18.9% were misidentified . Of 21 organisms tested at both institutions, those tested at JHH required additional tests for correct identification in 38.1% of cases, compared with 9.5% at HMC . Misidentification rates were identical (9.5%) in both centers . Of strains tested at HMC only, 86.8% were correctly identified without extra tests, 5.4% were identified with additional tests, and 7.8% were misidentified: corresponding data for JHH were 53.1, 21.9, and 25.0%, respectively . Of 53 strains tested in triplicate at JHH, 56.7% yielded the same result on each occasion, 37.7% were identical in two of three tests, and 5.7% gave different results on each of three occasions . Discrepancies between identification rates at HMC and JHH may be explained by differences in species tested (more commonly encountered species were tested at HMC) and interpretation of reactions by the two different readers . The RapID ANA method has the potential for rapid identification of clinically isolated anaerobes; however, accuracy and reproducibility may vary as a function of the specific laboratory setting. Pediatrics, 1985 Jun, 75(6), 1028 - 31 Nonspecific vaginitis following sexual abuse in children; Hammerschlag MR et al.; Nonspecific vaginitis, one of the most common causes of vaginitis in adults, is a polymicrobial infection in which vaginal anaerobes act synergistically with Gardnerella vaginalis . The diagnosis is made by examination of the vaginal secretions for clue cells, the development of a fishy odor after the addition of 10% KOH to vaginal secretions, and a vaginal pH greater than 4.5 . To determine whether nonspecific vaginitis occurs in sexually abused children, we obtained vaginal washes from 31 abused and 23 nonabused children, 21/2 to 13 years of age . A child was considered to have definite nonspecific vaginitis if her wash contained both clue cells and odor; she was considered to have possible nonspecific vaginitis if her wash contained either clue cells or odor . We did not use vaginal pH as a diagnostic criterion because the normal range has not been standardized in prepubertal girls . Possible nonspecific vaginitis (odor only) was found in only 1/23 (4%) of nonabused children . This girl was asymptomatic and findings from her examination were normal . Only one of the 31 abused children had possible nonspecific vaginitis (odor) detected at the initial examination, less than 48 hours after the episode of abuse, whereas 4/31 (13%) developed definite, and 4/31 (13%) possible nonspecific vaginitis at the follow-up visit more than seven days after the episode of abuse or rape . Five of these eight girls developed either a new vaginal discharge or dysuria; three were treated with metronidazole with resolution of their symptoms and reversion of the vaginal wash to normal.(ABSTRACT TRUNCATED AT 250 WORDS) Tokai J Exp Clin Med, 1985 Jun, 10(2-3), 181 - 92 Gastrointestinal decontamination in the compromised host and its clinical significance; Ozawa A et al.; The result documenting the disappearance of obligate anaerobic bacteria as the predominant intestinal organisms with the onset of septicemia from S . marcescens calls for exploration into the clinical significance of anaerobic bacteria in the intestine in relationships between gut flora and host . The finding that no significant difference could be seen between the rates of septicemia under protective isolation and in uncontrolled environments is indicative of the fact that the disease most likely originated as an infection of endogenous nature . In the five cases of leukemia in children with bone marrow transplantation cited in this presentation, not one case of bacterial or fungal infection was recorded . The establishment of endogenous infections surrounding the results presented herein is discussed in terms of the biological phenomena of the interaction between intestinal flora and host, and between the intestinal bacterial flora. Pathol Biol (Paris), 1985 Jun, 33(5 Pt 2), 573 - 6 {Study of the sensitivity of anaerobic bacteria using 2 dilution technics}; Tigaud S et al.; We studied forty-seven anaerobic strains recovered from blood cultures or pus from deep infections over three months . Antibiotic sensitivity was tested using two dilution techniques . For both, a standardized, controlled inoculum was used and strains with known susceptibilities were included . The first method consisted of dilution of antibiotics in Schaedler broth and MIC determination using microplates . In the second method, dilutions in Wilkins-Chalgren broth with 1.5 g/l agar and ATB-API plates were used; these plates are specially designed for anaerobes and have not yet been marketed . Advantages of dilution techniques for antibiotic sensitivity testing of anaerobes are recalled . Our findings establish that, under correct technical conditions, results of both methods studied are consistent. Zentralbl Bakteriol Mikrobiol Hyg {B}, 1985 Jun, 181(1-2), 64 - 70 {Mutagenic activity of nitrothiazole compounds}; Hof H; The mutagenic activities of different nitrothiazole derivatives were examined by the Ames-test . Such nitrothiazoles which display pronounced antibacterial properties against aerobic as well as anaerobic bacteria exert strong mutagenic activities . Thereby, both base pair substitution and frame-shift mutation occur . Reduction of the nitro-group of the nitrothiazoles by bacterial nitroreductases is a prerequisite for these mutagenic activities . In contrast, nitrothiazole derivatives which are unable to inhibit bacterial multiplication are also not mutagenic. J Clin Microbiol, 1985 Jun, 21(6), 875 - 9 Evaluation of three broth disk methods for testing the susceptibility of anaerobic bacteria to imipenem; Shungu DL et al.; Imipenem is a member of a new class of highly potent beta-lactam antibiotics, carbapenems, with an antibacterial spectrum that includes nearly all currently known aerobic and anaerobic bacterial species of clinical significance . Although relatively stable in most standard laboratory media used for antimicrobial susceptibility testing, imipenem undergoes rapid inactivation in thioglycolate broth, a recommended medium for susceptibility testing of anaerobic bacteria by the broth disk method . In the current study, a panel of 36 anaerobic bacteria consisting of 28 clinical isolates and eight quality control strains was used to determine the suitability and accuracy of the broth disk methods with brain heart infusion, Schaedler, and anaerobic broths, in comparison to the reference agar dilution method, for the anaerobic susceptibility testing of imipenem . To achieve single test concentrations of approximately 8, 16, and 64 micrograms/ml for imipenem, cefoxitin, and piperacillin, respectively, which correspond to the MIC breakpoints of the test drugs, four 10-microgram imipenem disks, three 30-microgram cefoxitin disks, and three 100-microgram piperacillin disks were used in 5 ml of broth . The correlation between the reference agar dilution method and each of the three broth disk elution procedures evaluated was excellent, for imipenem (100% agreement) and somewhat less so for cefoxitin and piperacillin . Therefore, brain heart infusion, Schaedler, and anaerobic broths, but not thioglycolate broth, are suitable for anaerobic susceptibility testing of imipenem by the disk elution method. J Antimicrob Chemother, 1985 Jun, 15 Suppl C, 183 - 8 Comparative in-vitro activity of Sch 34343 and other antimicrobial agents against anaerobic bacteria; Nord CE et al.; The activity of Sch 34343 was determined against 575 strains of anaerobic bacteria by an agar-dilution method . Its activity was compared with that of benzylpenicillin, piperacillin, cefoxitin, imipenem, clindamycin, metronidazole, chloramphenicol, vancomycin, fusidic acid and bacitracin . Sch 34343 and imipenem were the most active agents tested . Based on these results, Sch 34343 appears to be a promising antimicrobial agent for anaerobic infections and warrants further clinical investigations. Jpn J Antibiot, 1985 May, 38(5), 1355 - 67 {Studies of isolated organisms from otorhinolaryngological infections and their susceptibilities to macrolide antibiotics}; Baba S et al.; To study current situation of pathogenic bacteria and their drug resistance to macrolide antibiotics in the otorhinolaryngological infections, 609 strains diagnosed as pathogen derived from 463 patients were collected from cohospitals or institutions during the period of 1980-1983 . The results obtained were as follows: Gram-positive cocci (GPC) was dominant (410 strains) and major species were S . aureus (135 strains), S . pneumoniae (81 strains), S . epidermidis (68 strains) and S . pyogenes (65 strains) . In Gram-negative bacteria giving 147 strains and 43 strains, of anaerobes prevailing species were H . influenzae, P . aeruginosa and Peptostreptococcus spp . Representative species in the diseases were S . aureus (26.6%), S . epidermidis (24.5%), and P . aeruginosa (12.8%) in acute otitis media, S . aureus (34.4%), S . epidermidis (17.7%) and P . aeruginosa (14.6%) in acute exacerbation of chronic otitis media, S . epidermidis (17.0%), S . aureus (16.1%) and H . influenzae (13.4%) in acute paranasal sinusitis, S . pyogenes (29.1%), S . pneumoniae (19.6%) and S . aureus (15.1%) in acute tonsillitis . Although most of isolates were susceptible to macrolides, 62 resistant strains to macrolides were found in 501 strains and the resistant rates were 26.7% in S . aureus, 23.1% in S . epidermidis and 6.5% in S . pyogenes . The resistant pattern was somewhat different against each macrolides, resistant strains giving over 100 micrograms/ml in MIC were 55/62 in erythromycin, 35/62 in josamycin and midecamycin and 7/62 in TMS-19-Q, a new macrolide. Jpn J Antibiot, 1985 May, 38(5), 1279 - 86 {Basic and clinical studies on cefminox in the field of obstetrics and gynecology}; Tanada S et al.; Human pharmacokinetics and clinical studies of cefminox (CMNX, MT-141) were carried out and the following results were obtained . The concentrations of CMNX transferred to the uterus and its appendages after CMNX 1 g intravenous injection were maintained above 12.5 micrograms/g during first 3 hours or more . The concentrations of CMNX transferred to the pelvic dead space exudate were above 12.5 micrograms/ml during 6 hours or more . Those concentrations were sufficiently effective against the major pathogens (Gram-negative and anaerobic bacteria) demonstrated in the field of obstetrics and gynecology . We administered CMNX to 4 cases with postoperative infections at a dose of 2 g per day (twice a day) for a period of 4-6 days . The clinical effect was excellent in 3, good in 1 case . No side effect was observed. J Clin Pathol, 1985 May, 38(5), 565 - 9 Effect of the growth of anaerobic bacteria on the surface pH of solid media; Watt B et al.; Changes in surface pH occurring after varying periods of anaerobic incubation were measured for a total of 23 test solid media . There was little change in the surface pH of uninoculated plates, but plates inoculated with Bacteriodes fragilis showed a striking fall in pH, to pH 5 in the case of some of the test media . The problems of controlling the surface pH of solid media are discussed and possible methods of control are considered. J Am Vet Med Assoc, 1985 Apr 15, 186(8), 789 - 91 Ovine abortion associated with an anaerobic bacterium; Kirkbride CA et al.; An anaerobic, slightly curved, tapered, corrugated, rod-shaped bacterium with O to greater than 12 flagella at each pole was isolated from 2 aborted lambs with focal hepatic necrosis . The organism stained faintly Gram-negative, but stained better by the Giemsa method . It was pleomorphic in culture, ranging from filaments containing granules to faintly staining spheroids. Chemioterapia, 1985 Apr, 4(2), 186 - 91 Colonization of the oropharynx with pathogenic microorganisms--a potential risk factor for infection in compromised patients; Heimdahl A et al.; The indigenous oropharyngeal microflora is complex and consists of many different aerobic and anaerobic microorganisms . Nonindigenous pathogenic microorganisms do not normally colonize the oropharynx due to several different defense mechanisms such as cell specific bacterial attachment, secretion of antibacterial substances and immunoglobulins . Also microbial interactions play an important role in the prevention of new colonization of the oropharynx . Suppression of the indigenous flora by antibiotics promote new colonization . Patients that are severely compromised by disease may be infected by colonizing microorganisms . At special risk are patients with low neutrophil count and patients that are prone to aspiration pneumonia . Thus new colonization should be prevented in such risk patients . Careful monitoring of systemic antimicrobial therapy is essential and decontamination of oropharynx with local antimicrobial agents may be of value. Br J Surg, 1985 Apr, 72(4), 261 - 4 Antibiotic treatment during surgery for diffuse peritonitis: a prospective randomized study comparing the effects of cefuroxime and of a cefuroxime and metronidazole combination; Tornqvist A et al.; In a prospective randomized open study of patients operated upon for diffuse peritonitis, the effects of two different antibiotic regimens were evaluated . Cefuroxime given as a single drug (Group I; n = 59) was compared with a combination of cefuroxime and metronidazole (Group II; n = 63) . Bacteriological cultures, both aerobic and anaerobic, were obtained peroperatively and in the event of any complication . The antibiotic sensitivities of isolated bacteria, and the serum and tissue concentrations of cefuroxime were determined . Postoperative infectious complications occurred in 22 per cent of Group I patients (cefuroxime), and in 17.5 per cent of Group II (cefuroxime plus metronidazole) . The mortality rates were 5 per cent for Group I and 8 per cent for Group II . Tissue concentrations of cefuroxime were well above the MIC (minimal inhibiting concentration) values for most of the bacteria isolated . From a few patients in Group I, however, cultures were obtained with isolates sensitive to metronidazole but resistant to cefuroxime . Our findings suggest that, in the antibiotic treatment of patients operated for diffuse peritonitis, an agent which is primarily effective against aerobic bacteria (but not entirely without effect on anaerobes) is as effective as combination therapy covering both aerobic and anaerobic bacteria. J Surg Res, 1985 Apr, 38(4), 356 - 63 A possible beneficial effect of metronidazole in reducing TPN-associated liver function derangements; Freund HR et al.; Cholestasis and fatty infiltration of the liver are common complications of total parenteral nutrition (TPN) . Following a recent suggestion that TPN-associated liver function derangements may be related to intestinal overgrowth of anaerobic bacteria, the effect of metronidazole on hepatic dysfunction during TPN in rats was investigated . After 5 days of TPN with either amino acids and glucose or amino acids with glucose and fat, all groups exhibited a mild weight gain, positive nitrogen balance, increased liver weight, increased liver:body weight ratio, increased levels of liver enzymes, and increased hepatic lipid content . The administration of metronidazole at 15 mg/kg/day significantly decreased the hepatic lipid content from 0.077 g fat/g liver for controls to 0.053 g fat/g liver . The efficacy of metronidazole in reducing hepatic fat accumulation during nutritionally effective and adequate TPN in rats suggests the possible involvement of anaerobic bacterial flora of the intestinal tract, at least in part, in the pathogenesis of TPN-associated liver function derangements . However, the various biochemical and morphological expressions of these changes and the discrepancy between unchanged liver weight, liver:body weight ratio, liver enzymes, and the improved hepatic fat content suggest multifactorial mechanisms for TPN-related liver damage. J Clin Microbiol, 1985 Apr, 21(4), 645 - 6 Adaptation of a coculture technique to the Minitek anaerobe system; Hussain Z et al.; A method to produce anaerobic conditions by coculture with a nonfermentative organism was utilized in conjunction with the Minitek anaerobe system (BBL Microbiology Systems, Cockeysville, Md.) for identification of anaerobic bacteria from clinical specimens . With the coculture method, the Minitek anaerobe identification tests could be incubated under aerobic conditions . In 1,900 individual biochemical reactions, 1,826 (96%) were identical whether anaerobic conditions were achieved by conventional or coculture techniques . In comparison with the reference identification (Virginia Polytechnic Institute and State University, Blacksburg), both systems of incubation identified 91 of 99 strains (92%) correctly . The method of incubation had an effect on identification to the genus level in 1 of 99 (1%) strains and to the species level in 3 of 99 (3%) strains. Surgery, 1985 Apr, 97(4), 402 - 8 Should antimicrobial prophylaxis in colorectal surgery include agents effective against both anaerobic and aerobic microorganisms? A double-blind, multicenter study . The Norwegian Study Group for Colorectal Surgery; Carriage of Gardnerella vaginalis and anaerobes in semen; Gardnerella vaginalis was isolated from 22 (38%) of 58 semen samples obtained from men attending an infertility clinic . Counts ranged from 1.2 X 10(3) to greater than 10(7) colony forming units (cfu)/ml . There was no association between the isolation of G vaginalis and the sperm count . Twenty (34.4%) samples contained non-sporing anaerobes and nine (15.5%) both anaerobes and G vaginalis . The infective dose of G vaginalis is not known, but semen could act as a medium for its sexual transmission. Genitourin Med, 1985 Apr, 61(2), 114 - 9 Anaerobes and Gardnerella vaginalis in non-specific vaginitis; Hill LV; Clinical evidence of bacterial vaginosis was present in 25 (35%) of 72 patients attending a London venereology clinic and correlated significantly with abnormal organic acids in vaginal secretions (24/25), with Gardnerella vaginalis on culture (17/25), with complaints of vaginal malodour (15/25), and with a relative scarcity of white blood cells in vaginal secretions . Anaerobic vaginal flora were presumptively identified by gas-liquid chromatographic analysis of organic acids found in vaginal secretions . The clinical criteria used to diagnose bacterial vaginosis included the presence of at least three of the four following characteristics: (a) a vaginal pH greater than or equal to 4.5, vaginal secretions that (b) were homogeneous, (c) contained "clue" cells, and (d) released a "fishy" amine odour when mixed with 10% potassium hydroxide . Because 17 of the 25 patients with clinical bacterial vaginosis had both chromatographic bacterial vaginosis and G vaginalis, causative organisms were difficult to identify . None of the six patients who had G vaginalis but not chromatographic bacterial vaginosis had clinical bacterial vaginosis, but seven of the 10 women with chromatographic bacterial vaginosis but not G vaginalis had clinical bacterial vaginosis (p less than 0.02, chi 2 with Yates's correction) . This finding supports the recent suggestions that anaerobes are important in the production of clinical signs of bacterial vaginosis. J Med Microbiol, 1985 Apr, 19(2), 181 - 6 Comparison of media with and without 'Panmede' for the isolation of Streptobacillus moniliformis from blood cultures and observations on the inhibitory effect of sodium polyanethol sulphonate; Shanson DC et al.; Fastidious anaerobe broth and brain-heart infusion cysteine broth supplemented with 'Panmede' (a papain digest of ox liver) 2.5% supported the recovery of five Streptobacillus moniliformis strains from simulated blood cultures . Other media tested in parallel--brain heart infusion cysteine broth without 'Panmede' and Brewer's thioglycollate broth--were unreliable . Sodium polyanethol sulphonate (Liquoid) 0.05%, inhibited five isolates of S . moniliformis, including isolates from patients with Haverhill Fever . Occasionally, Liquoid 0.025% was also inhibitory and a heavy inoculum of one strain, NCTC11194, was completely inhibited by Liquoid 0.012% in simulated nutrient-broth blood cultures . These results suggest that the choice of media included in each blood-culture set is critical for the optimal isolation of S . moniliformis . Brain-heart infusion cysteine broth supplemented with 'Panmede', or commercially available fastidious anaerobe broth, without Liquoid, is recommended. Int J Gynaecol Obstet, 1985 Apr, 23(2), 153 - 6 Effect of Copper T intrauterine device on cervico-vaginal flora; Wahab SA et al.; The effect of the Copper T intrauterine device (IUD) insertion on vaginal and cervical flora was studied in thirty cases . The vaginal and cervical cultures showed a significant increase (P less than 0.01) in some of the anaerobic bacteria . Some of the aerobic organisms showed a statistically significant increase in the cervical cultures (P less than 0.01) . Strict asepsis during insertion of the device is recommended. Clin Lab Med, 1985 Mar, 5(1), 59 - 65 Anaerobic identification systems; Rosenblatt JE; Commercially produced prepackaged "kit" microsystems were evaluated for the identification of anaerobes . The API 20A and Minitek Anaerobe II systems by themselves were inadequate; even with the use of supplemental tests, agreement of identifications with a conventional method was only fair . AnIdent is a new and radically different system that provides accurate identifications after only 4 hours' incubation in room air without the need for a significant number of supplemental tests. Mikrobiologiia, 1985 Mar-Apr, 54(2), 324 - 6 {Use of molecular sulfur as an agent oxidizing H2 by a facultative anaerobic Pseudomonas strain}; Balashova VV; Pseudomonas Z-731, subspecies P . mendocina, was grown under anaerobic conditions in the atmosphere of hydrogen . Apart from hydrogen nitrate reduction and Fe3+ reduction, the organism was able to reduce S0, S2O3 and SO3 with the formation of H2S . The reduction of S0 with hydrogen was shown to be typical of certain facultative anaerobic microorganisms. Med Clin North Am, 1985 Mar, 69(2), 345 - 60 Brain abscess; Kaplan K; The results of CT brain scan in diagnosing and monitoring the course of brain abscesses and the recognition of the major role that anaerobic bacteria play in causing this disease have led to a reduction in disease mortality and have allowed a greater percentage of infected patients to recover without major neurosurgical procedures . Monitoring intracranial pressure, the availability of new antibiotics, and recognition and treatment of some of the more unusual syndromes associated with defective or suppressed immune systems have helped lead to a reduction in disease mortality from about 50 per cent to 10 per cent with excellent functional recovery in the majority of the patients. J Clin Microbiol, 1985 Mar, 21(3), 298 - 301 Detection of Mycoplasma hominis septicemia by radiometric blood culture; Smaron MF et al.; The ease with which Mycoplasma hominis can be recovered and the frequency of its occurrence in septicemia may not be fully appreciated . We detected the growth of M . hominis radiometrically with an automated blood culture instrument . The organism grew in both aerobic and anaerobic culture media, but the cultures were not visibly positive . It was necessary to stain the cultures with acridine orange to visualize M . hominis and to subculture them on Columbia base sheep blood agar to confirm the positive growth index indicated by the instrument . Sodium polyanetholesulfonate inhibited the growth of M . hominis and is not recommended for use as the anticoagulant when blood is cultured for Mycoplasma spp. Can J Surg, 1985 Mar, 28(2), 180 - 2 Fournier's gangrene; Joo P et al.; Fournier's disease--gangrene of the penis and scrotum--is an uncommon condition . During the past 6 years, five patients, whose cases are described, were admitted to Toronto General Hospital with this diagnosis . Four had preceding trauma (ischiorectal abscess, puncture wound, surgery) and four had pre-existing debilitating problems (diabetes, rectal carcinoma, acute lymphocytic leukemia, alcoholic cirrhosis) . Appropriate treatment must include urgent radical surgery to remove all necrotic tissue, and combination antibiotic therapy directed against the likely organisms, which are aerobic gram-negative rods, gram-positive cocci and anaerobes . Clindamycin in combination with tobramycin or gentamicin proved to be effective in this series. Jpn J Antibiot, 1985 Mar, 38(3), 575 - 94 {Clinical and bacteriological evaluation of TMS-19-Q in superficial suppurative skin and soft tissue infection}; Watanabe S et al.; Clinical effectiveness of TMS-19-Q, a new macrolide antibiotic, was evaluated in superficial infectious diseases classified into 6 groups at 13 departments of dermatology . The results obtained were as follows: Final global improvement rating in 311 cases were excellent in 91, good in 158, fair in 45 and poor in 17 and the effective rate was 80.1% . Effective rates in each group were 71.1% in 1st group (folliculitis and acne pustulosa), 78.6% in 2nd group (furuncle, furunculosis and carbuncle), 100% in 3rd group (impetigo), 76.9% in 4th group (phlegmone, superficial lymphangitis, erysipelas and infectious paronychia), 88.7% in 5th group (inflammatory atheroma, subcutaneous abscess, hidradenitis suppurative and acne conglobata) and 77.3% in 6th group (secondary infection) . Dominant strains isolated were S . aureus (40.7%), S . epidermidis (26.9%) and anaerobic bacteria (20.8%) . S . aureus was frequently isolated from most of all disease . On the other hand, S . epidermidis and anaerobic bacteria were isolated mainly from 1st and 5th group . Optimum daily doses would be over 600 mg . Slight adverse reactions such as gastrointestinal disorders, eruption and malaise were observed in 12 cases. Rev Infect Dis, 1985 Mar-Apr, 7(2), 151 - 70 Mechanisms of microbial synergy in polymicrobial surgical infections; Rotstein OD et al.; Surgical infections are almost always polymicrobial, yet the critical importance of bacterial mixtures in these infections has received relatively little attention . The convincing data on the prevalence of mixed infections in surgery are reviewed . Both clinical and experimental evidence indicate that true synergy between certain aerobes and anaerobes may exist . Of the possible mechanisms of synergy, the most important seems to be the ability of anaerobes, their metabolic products, or their capsules to inhibit phagocytosis of aerobes by leukocytes . Other mechanisms of importance in special microbial combinations include provision of essential nutrients such as vitamin K, succinate, and various growth factors by one microbe to the other; alteration of local environment, including reduction of the oxygen tension and lowering of redox potential; and the provision of substances toxic to the host that permit species of bacteria to flourish concurrently . Further study of these interactions will shed light on the causes and correction of treatment failure. J Clin Periodontol, 1985 Mar, 12(3), 201 - 8 Susceptibility of human oral anaerobic bacteria to antibiotics suitable for topical use; Baker PJ et al.; 17 antibiotics, with potential for topical use, were tested for their activity against the human oral flora . Concentrations (mumol/l) required to inhibit 90% of test strains are presented and drug activities are compared . The total cultivable oral flora was susceptible to the tetracyclines including tetracycline itself, minocycline, doxycycline, and oxytetracycline and to erythromycin . On the other hand, actinobolin, kanamycin, neomycin, streptomycin, spiramycin, tyrothricin, vancomycin, clindamycin, and chloramphenicol were ineffective against many of the human oral anaerobic bacteria even at high concentration . Penicillin was effective at high concentrations but could not be recommended because organisms which are not inhibited by low concentrations are penicillinase producers . Carbenicillin was effective against all organisms except Actinobacillus actinomycetemcomitans . The gram-negative organisms involved in adult periodontitis were most susceptible to the tetracyclines, tyrothricin, carbenicillin and clindamycin, while those associated with localized juvenile periodontitis were susceptible to the tetracyclines or erythromycin . These data, combined with the previous findings that some tetracyclines exhibit marked substantivity and collagenase inhibition activity, indicate that tetracycline or minocycline are likely to be good choices in the treatment or prevention of oral diseases. Antimicrob Agents Chemother, 1985 Mar, 27(3), 427 - 8 Comparative activity of ciprofloxacin against anaerobic bacteria; Sutter VL et al.; The in vitro activity of ciprofloxacin was assessed against 362 strains of anaerobic bacteria and compared with that of cefoxitin, clindamycin, metronidazole, and mezlocillin . Only 31% of the strains tested were susceptible to ciprofloxacin . The other agents were active against most of the strains tested. Am J Med, 1985 Feb 8, 78(2A), 2 - 10 Aztreonam: the first monobactam; Sykes RB et al.; A novel screening procedure led to isolation of the structurally unique, bacterially produced, monocyclic beta-lactam antibiotics early in 1979 . These naturally occurring "monobactams" were not clinically useful as antibiotics because of their poor antibacterial properties . They were, however, found to interact with certain penicillin-binding proteins of bacteria and thus to interfere with the biosynthesis of bacterial cell walls . The focus of monobactam development then turned toward increasing the binding activity of the beta-lactam ring of the molecule . Aztreonam was the first compound to emerge that fulfilled the objectives of the program . It is relatively inactive against gram-positive and anaerobic bacteria but is extremely effective against aerobic gram-negative bacteria, even in low concentrations . In addition, it is highly resistant to enzymatic hydrolysis by beta-lactamases and demonstrates a high degree of stability against plasmid-mediated gram-negative lactamases . With the chromosomally mediated beta-lactamases, on the other hand, aztreonam can act either as an inhibitor or as a poor substrate . It is unique in that it does not induce production of chromosomally mediated enzymes . Interference with normal gut flora by the use of broad-spectrum antibiotics can result in decreased defense capacity and can lead to intestinal colonization by resistant pathogenic organisms . Therapy directed specifically against the invading pathogen is thus preferred . Such directed therapy is provided by aztreonam . Its narrow spectrum can, if necessary, be broadened by combining it with other antibiotics while continuing to maintain an alternative to the more generalized "shotgun" therapy with its attendant side effects such as disturbances of the natural gut flora, diarrhea, and the emergence of resistant bacteria. Arch Microbiol, 1985 Feb, 141(1), 1 - 7 Oxalobacter formigenes gen . nov., sp . nov.: oxalate-degrading anaerobes that inhabit the gastrointestinal tract; Allison MJ et al.; This report describes a new group of anaerobic bacteria that degrade oxalic acid . The new genus and species, Oxalobacter formigenes, are inhabitants of the rumen and also of the large bowel of man and other animals where their actions in destruction of oxalic acid may be of considerable importance to the host . Isolates from the rumen of a sheep, the cecum of a pig, and from human feces were all similar Gram-negative, obligately anaerobic rods, but differences between isolates in cellular fatty acid composition and in serologic reaction were noted . Measurements made with type strain OxB indicated that 1 mol of protons was consumed per mol of oxalate degraded to produce approximately 1 mol of CO2 and 0.9 mol of formate . Substances that replaced oxalate as a growth substrate were not found. Aust N Z J Obstet Gynaecol, 1985 Feb, 25(1), 55 - 8 Single dose tinidazole prophylaxis in hysterectomy; Crosthwaite AH et al.; The results of this randomized double blind, placebo controlled trial of a single oral dose of 2 g tinidazole or placebo approximately 12 hours before hysterectomy showed the incidence of infective morbidity in patients who received placebo was 12.2% compared with 1.9% in patients who received tinidazole, (p = 0.045) . The mean serum concentration of tinidazole at the time of surgery was 35 mcg/ml, which was well in excess of the minimum concentration required to inhibit all of the 95 anaerobes isolated in this study . Serum tinidazole concentration remained adequately inhibitory for at least 24 hours after surgery . The ability of tinidazole prophylaxis to reduce further our already low rate of febrile morbidity was considered a worthwhile gain . It is now Unit policy to give this agent prophylactically to all patients if the integrity of the vagina is likely to be breached at the time of surgery. J Am Dent Assoc, 1985 Feb, 110(2), 194 - 8 Microwave sterilization; Rohrer MD et al.; This study has shown that representative fungi, viruses, and aerobic and anaerobic bacteria, including spore formers, can easily be killed in a conventional microwave oven with proper modifications . Metal instruments, including air turbine handpieces and burs, and acrylic dentures can be sterilized in short periods . Consistent sterilization can be accomplished only if the items to be sterilized are rotated in a three-dimensional manner throughout the microwave cavity . Arcing back to the magnetron and damage to the microwave oven are prevented by placing a radar absorbent material within the oven and with proper insulation of the item to be sterilized. Infect Immun, 1985 Feb, 47(2), 540 - 3 Prevention of adhesion by indigenous bacteria to rabbit cecum epithelium by a barrier of microvesicles; Hill RH; None of 74 strains of anaerobic bacteria cultured from the mucosal epithelial interface of the rabbit cecum adhered to isolated brush borders in experiments in which enteropathogenic Escherichia coli RDEC-1 was used as an adherent control . Scanning electron microscopy of the surfaces of the cecal epithelia confirmed that few organisms were in contact with the villus surface, but transmission electron microscopy revealed a layer of microvesicles up to 50 nm in diameter between the microvilli and mucous gel . The evidence indicates that there is no significant epithelium-adherent flora in the cecum but that a microvesicular layer could contribute significantly to prevention of adherence by both normal and potentially pathogenic bacteria. Digestion, 1985, 32(2), 99 - 105 Toxic products in hemorrhagic ascitic fluid generated during experimental acute hemorrhagic pancreatitis in dogs and a treatment which reduces their effect; Satake K et al.; Toxic substances produced in hemorrhagic ascitic fluid during experimental hemorrhagic pancreatitis in dogs were investigated . An average of 394 ml of ascitic fluid was produced within 5 h after the induction of acute pancreatitis by intraductal injection of a mixture of autologous bile and trypsin . Hemorrhagic ascitic fluid was collected under sterile conditions, which was confirmed by aerobic and anaerobic culture and a Limulus test . The sterile fluid was injected intraperitoneally into mice in doses of 2 and 3 ml, and the mortality rate 72 h after injection was 66.0 and 88.4%, respectively . It contained high concentrations of pancreatic enzymes, including trypsin and esterase activity, as well as bradykinin, histamine and prostaglandin . Autopsy and histological examination of mice revealed shock with lung damage . The results suggest that hemorrhagic ascitic fluid produced in pancreatitis may be an important factor for early deaths in acute pancreatitis . When a new synthetic antiprotease (nafamstat mesilate) in a dosage of 0.2 mg was mixed with 1 ml of ascitic fluid, trypsin was not detectable, and bradykinin was reduced 1.0 ng/ml from 8.0 ng/ml, while esterase activity decreased to one tenth of its previous activity . The mortality following injection of the solution decreased to 26.7 and 80.6%, respectively . These results indicate that peritoneal lavage with a solution containing antiprotease may be an effective treatment for hemorrhagic acute pancreatitis. Vestn Khir Im I I Grek, 1985 Jan, 134(1), 17 - 23 {Clinical picture, diagnosis and treatment of anaerobic abscess of the lung and pleurisy}; Kolesov AP et al.; Bacteriological examinations of 65 patients with abscesses of lungs and pleuritis have shown that non-sporulating anaerobic bacteria were isolated in 85% of purulent foci (without a concomitant aerobic microflora) . Express-methods of diagnosis taking only 30-40 minutes give opportunities for early etiotropic therapy . Best results of treatment of anaerobic abscesses of lungs and pleuritis were obtained by a combination of sufficient drainage with the purposeful antianaerobic therapy. Br J Dis Chest, 1985 Jan, 79(1), 1 - 8 Use of gas liquid chromatography in the clinical diagnosis of anaerobic pleuropulmonary infection; Hunter JV et al.; Evidence of anaerobic infection was sought in 83 patients with pulmonary disease with anaerobic culture and gas liquid chromatography (GLC) of mucopurulent sputum, or pleural fluid where appropriate . Saliva samples from nine healthy controls and 14 patients with cystic fibrosis were examined by the same methods to assess anaerobic content . Clinically significant anaerobic pleuropulmonary infection was not found in our patients with bronchitis, bronchiectasis and cystic fibrosis and occurred in only some of our patients with empyema and lung abscess . GLC of pleural fluid (empyema) or sputum (lung abscess) was helpful in identifying these cases, when a strongly positive reading was obtained . The gas liquid chromatogram was negative or only weakly positive in those patients where the presence of anaerobes was clinically insignificant, most probably resulting from contamination of the sputum samples by saliva . Results were rapidly available and the need for transtracheal aspiration to obtain specimens of bronchial secretion uncontaminated by mouth flora was avoided . The semiquantitative GLC would therefore appear to be a useful method for investigating specimens from patients with suspected anaerobic pleuropulmonary infection. Can J Surg, 1985 Jan, 28(1), 11 - 3 Pelvic inflammatory disease and the general surgeon; Boyd ME; New causal agents of pelvic inflammatory disease that have recently been determined are Chlamydia trachomatis, anaerobic bacteria and penicillinase-producing gonococci . It is also recognized that the pelvic infection is normally polybacterial . The symptoms produced by these organisms are so indefinite that diagnosis based on clinical findings alone is often difficult . The diagnosis of pelvic inflammatory disease should therefore be established by laparoscopy in these cases . Antibiotics capable of eradicating most pelvic infections are now available . As a result of their use, the primary therapy has become medical . The indication for surgery is, in essence, failed medical therapy . Ablative surgery should generally be delayed until adequate antibiotic therapy has been tried and found inadequate . Furthermore, the surgery should be conservative because the disease is often unilateral . Total abdominal hysterectomy and bilateral salpingo-oophorectomy as a treatment for pelvic inflammatory disease should be the exception rather than the rule. Am Fam Physician, 1985 Jan, 31(1), 143 - 9 Salpingitis and pelvic inflammatory disease; Swinker ML; Chlamydia trachomatis is becoming an increasingly important etiologic agent . The physician must also be aware of other nongonococcal causes of pelvic inflammatory disease, such as Mycoplasma, Ureaplasma, coliforms and anaerobes . Epidemiologic characteristics of the various microorganisms differ, with the frequency of nongonococcal disease higher in older women . Intrauterine devices increase the potential for pelvic inflammatory disease . The rising incidence of nongonococcal and dual infections has led to therapeutic and preventive techniques aimed at multiple etiologies. Surg Gynecol Obstet, 1985 Jan, 160(1), 20 - 6 Perforation of the gastrointestinal tract and peritonitis in the neonate; Bell MJ; A review of 60 neonates with perforation of the gastrointestinal tract and peritonitis was undertaken to evaluate efficacy of current treatment . Perforation was most frequently associated with necrotizing enterocolitis, spontaneous gastric perforation, intestinal obstruction and feeding tube perforation of the duodenum . Primary closure of proximal gastrointestinal tract perforations and resections with diversion for distal perforations were the commonly used operative procedures . Mortality was 33 per cent, with most deaths (80 per cent) a result of sepsis or its complications . Increased risk of mortality was associated with lower birth weight and lower weight for gestational age, males, initial serum pH less than 7.30, delay in surgical treatment and feeding tube perforation . Peritoneal cultures were dominated by aerobic and facultative organisms with only 21 per cent yielding mixed aerobic-anaerobic cultures . No anaerobes were retrieved from post-operative wound infections or abscesses, and only one of 22 positive blood cultures yielded an anaerobe . Antibiotic therapy included combinations of aminoglycoside beta-lactam antibiotics and clindamycin . Improving survival in this population, particularly in infants less than 1 kilogram birth weight, was demonstrated. J Basic Microbiol, 1985, 25(9), 603 - 19 Nature and significance of microbial cometabolism of xenobiotics; Janke D et al.; Microbial cometabolism, i.e . "transformation of a non-growth substrate in the obligate presence of a growth substrate or another transformable compound" (Dalton and Stirling 1982) is a whole-cell phenomenon physiologically based on coupling of different catabolic pathways at the cellular level . It is frequently observed in transformation of xenobiotic non-growth substrates by individual microbial species . Transformation processes of this type are usually mediated by appropriate non-specific enzymes of the peripheric cellular metabolism able to modify a variety of substances other than their natural substrates . The precise mechanisms of coupling between metabolism of xenobiotic non-growth substrates and of particular additional carbon substrates may be different depending on the substrates and the microbial species involved . However, experimental data indicate that the primary function of the respective additional carbon substrates is to supply either energy, cofactors or metabolites for the different cellular events involved in the transformation process (e.g . uptake of the xenobiotic non-growth substrate, functioning of appropriate degradative enzymes of the peripheric cellular metabolism) . Cometabolism of xenobiotics involves nothing special or novel from the standpoint of biochemistry . On the contrary, there are numerous examples where the turnover of particular natural compounds by certain aerobic or anaerobic microorganisms is essentially based on coupling of different catabolic pathways at the cellular level by transfer of hydrogen (i.e . reducing power) and/or energy between two or more enzymatic reactions . Synthetic chemicals which resist total degradation by individual microbial species may undergo mineralization due to complementary catabolic sequences mediated by certain multispecies microbial associations with cometabolic transformations being the initial steps . Although taking place in certain natural habitats (e.g . rhizospheres, sewage), microbial cometabolism of xenobiotics in natural ecosystems occurs with slow rates since the respective cometabolizing populations are generally small and will not increase in number or biomass in response to the introduced chemicals . However, under conditions of axenic microbial cultures, high concentrations of biomass, and appropriate substrate mixtures cometabolism of synthetic chemicals may be a useful technique of considerable practical importance to accumulate biochemical products at high yields . In addition, cometabolic capabilities of wild-type microorganisms may serve as a tool for the construction of microbial strains with a new degradative potential for recalcitrant xenobiotic compounds. Acta Chir Scand, 1985, 151(2), 163 - 8 Single-dose intravenous metronidazole v . doxycycline prophylaxis in colorectal surgery . An open prospective, randomized trial; Kling PA et al.; In an open prospective, randomized study of antimicrobial prophylaxis in colorectal surgery, using a single intravenous dose, metronidazole (1 g) was more effective than doxycycline (0.2 g) . The difference in infection rates (2/41 = 5% v . 7/33 = 21%) was statistically significant . Prolonged administration of either agent (2-7 days) yielded results comparable to those with single doses . Five emergency cases were admitted to the study . In two of them, a metronidazole-based therapeutic regimen prevented postoperative infection, whereas infection occurred in all 3 patients given doxycycline therapy . The total infection rate after elective surgery was 4% with metronidazole and 25% with doxycycline prophylaxis . The infections in the metronidazole group were superficial and caused by Escherichia coli, whereas half of the infections in the doxycycline group were intra-abdominal and due to intestinal aerobic and/or anaerobic bacteria . In contrast to doxycycline, therefore, metronidazole prevented postoperative anaerobic infection and was associated with low incidence of aerobic infection. Scand J Infect Dis Suppl, 1985, 46, 89 - 95 Treatment of anaerobic infections: an overview; Finegold SM; Increasing resistance on the part of anaerobes to several antimicrobial agents has been a problem in recent years . Mechanisms of resistance include production of inactivating enzymes such as beta-lactamases, plasmid-mediated transferable resistance and failure of the drug to penetrate the bacterial cell . Fortunately, availability of several new agents permits us to treat anaerobic infections effectively . However, it is now desirable to do routine in vitro susceptibility testing of anaerobes, especially in seriously ill patients . Newly introduced drugs and others still undergoing study are compared with the standard agents. Scand J Infect Dis Suppl, 1985, 46, 82 - 8 Concepts of anaerobic infection in relation to prevention and management; Collee JG; Concepts of anaerobic infection are reviewed in relation to the management of wounds that might be contaminated by facultative or anaerobic organisms or mixtures of these . Considerations of post-operative wound infections oblige us to consider the indications for per-operative antimicrobial prophylaxis and to bear in mind the role of anaerobes and the possibility of pathogenic synergy in these situations . Pathogenic associations of anaerobes with other organisms are further considered in relation to periodontal disease and anaerobic vaginosis . The various roles of anaerobes in enteropathogenic conditions are briefly considered . There is a continuing obligation on clinical bacteriologists and clinicians to work together towards the more effective prevention and management of infections that may or may not have a significant anaerobic component. Scand J Infect Dis Suppl, 1985, 46, 72 - 81 Safety of nitroimidazoles; Roe FJ; The nitroimidazoles used in the treatment of anaerobic infection are well-tolerated by patients . With the possible exception of neurotoxic effects associated with high dosage, signs and symptoms of toxicity are transient and disappear soon after withdrawal of treatment . Teratogenicity tests in animals have given negative results in the case of metronidazole, ornidazole and tinidazole, and in the case of metronidazole no evidence of any adverse effect on the outcome of pregnancy was seen in women treated for trichomoniasis at various times during gestation, including the first trimester . The observed low general toxicity of nitroimidazoles is consistent with the non-occurrence of nitroreduction, as is the absence of chromosomal aberration in the circulating lymphocytes of patients receiving prolonged metronidazole therapy for Crohn's disease . Carcinogenicity tests involving the prolonged exposure of rats, mice and hamsters to a range of doses of metronidazole have given mixed results . In response to high doses, mice exhibited an increased risk of developing lung tumours, and female rats developed more liver tumours than controls . However, these effects may have been non-specific consequences of prolonged high dosage . No excesses of tumours were seen in response to lower doses and two tests in hamsters gave negative results . A follow-up of 771 women treated, 10 or more years previously, with metronidazole revealed no excess cancer risk . Thus the available information suggests that metronidazole, tinidazole and other 5-nitroimidazoles effective against anaerobic microorganisms are very safe both in the short-term and in the long-term. Drugs Exp Clin Res, 1985, 11(11), 761 - 4 Susceptibility of anaerobic bacteria to metronidazole . A bacteriological and clinical study; Gubina M et al.; The activity of metronidazole was studied by the diffusion method using two discs on a model group of 40 anaerobic bacterial strains isolated recently from clinical specimens . The minimal inhibitory concentrations (MICs) were determined by the dilution method and regression curves by the method of minimum square errors . Some 82.5% of bacteria of the model group were susceptible to metronidazole . All the routinely isolated anaerobes (582 strains) were tested with metronidazole over a period of 20 months . Susceptibility was recorded in 469 strains (80.6%) . The clinical study was carried out on two groups of inpatients with bacteriologically confirmed mixed aerobic and anaerobic infections . Subjects in Group 1 (25 patients) were given clindamycin and gentamicin and those in Group 2 (30 patients) metronidazole and gentamicin . The results showed that the two combinations of drugs had comparable effects. Drugs Exp Clin Res, 1985, 11(6), 387 - 92 A non-absorbable rifamycin for treatment of hepatic encephalopathy; Testa R et al.; Ammonia (NH3) plays a role in hepatic encephalopathy (HE) . Agents affecting colonic ammonia production, such as non-absorbable antibiotics, decrease plasma levels of NH3 and findings of HE . The short-term efficacy of a non-absorbable rifamycin, rifaximin, was studied in comparison with paramomycin in 20 cirrhotic patients with high levels of NH3 and impaired number connection test (NCT) . Both antibiotics significantly decreased ammonia-producing colonic bacteria . Rifaximin proved to be active on both aerobic and anaerobic bacteria and is thus effective, even at the dosage used, in the treatment of HE. Childs Nerv Syst, 1985, 1(6), 324 - 8 Brain abscess in childhood; Theophilo F et al.; The author review 10 years' experience in managing brain abscess in childhood: 19 cases were treated in children from 1 to 18 years old . The etiology was rhinogenic in 5 cases, congenital heart disease in 5, hematogenous in 3, traumatic in 3, postoperative in 1, and unknown in 3 cases . Brain abscesses that developed by direct spread were located nearby the source, whereas metastatic abscesses (such as cardiogenic or hematogenous) in most cases spread via the vertebral-basilar system, usually developing in the parieto-occipital regions . Four of the 5 cases with multiple abscesses were cardiogenic and one hematogenous . The most important neurological signs were paresis (10 cases) and cranial nerve involvement (10 cases) . Six abscesses were sterile and 6 grew aerobic and 6 anaerobic bacteria . In one case, aerobic as well as anaerobic bacteria were found . Fifteen patients were treated preoperatively with antibiotics . The treatment was operative in 17 cases . In two cases, gravely ill on admission, no surgical treatment was given . The etiology, localization, bacteriology, surgical methods, and results in those cases are discussed. C R Acad Sci III, 1985, 300(18), 669 - 72 {Optimization of the growth of anaerobic bacteria by addition of a perfluorinated oil}; Ceschin C et al.; Strict anaerobic bacteria require special conditions of culture; their obtention in the laboratory therefore is difficult especially for poor inocula . A method for stimulating anaerobes growth is described: a perfluorinated oil in which CO2 has been dissolved is added to the classical culture medium . The latency phase of the bacterial growth is strongly decreased especially for poor inocula . Whatever the inoculum and the gas bubbling time are, the rate of growth remains constant . The changes in bubbling times do not induce significant differences in latency time . This technique has been also applied to the starting of lyophilized strains. Zentralbl Bakteriol Mikrobiol Hyg {B}, 1984 Dec, 179(6), 555 - 65 {Evaluation of procedures for vaginal disinfection}; Wewalka G et al.; At the occasion of the usual preparations preceding gynecological operations the average vaginal bacterial release of 42 patients, already anaesthesized, was assessed by a rinsing technique to be 5,04 +/- 0,98 log10 c.f.u . per ml sampling fluid after aerobic and anaerobic culture . The reduction of this bacterial release caused by the measurement itself is relatively small, therefore the technique was found to be suitable for evaluation of the efficacy of germreducing measures like irrigation or disinfection . An irrigation with isotonic saline during 30 s was measured to reduce the vaginal bacterial release by 0,4 +/- 0,5 log-steps . A solution containing 0,08% chlorhexidine gluconate + 0,1% benzalkon gluconate applicated during 5 min caused a reduction of 1,04 +/- 0,76 and a watery solution of povidone-iodine one of 2,29 +/- 1,00 log-units when used for 3 min . When after disinfection the sustained antimicrobial action of the chlorhexidin-containing preparation was not neutralized already during the sampling process by Tween 80 + lecithine + histidine being contained in the sampling fluid, an erroneously optimistic log reduction of 2,35 +/- 0,48 was measured . From the results it was calculated that 17-23 volunteers are necessary in order to detect with sufficient statistical safety an observed mean log reduction to be 0,5 log-units smaller than a hypothetical minimal reduction of 2,00 log-steps as required provisionally on an arbitrary basis. J Antibiot (Tokyo), 1984 Dec, 37(12), 1572 - 8 Irumamycin, an antifungal 20-membered macrolide produced by a Streptomyces . Taxonomy, fermentation and biological properties; Omura S et al.; Irumamycin is a new 20-membered macrolide antibiotic isolated from a culture broth of a soil isolate which was named Streptomyces subflavus subsp . irumaensis AM-3603 . It is active in vitro against some phytopathogenic fungi, but inactive against most aerobic and anaerobic bacteria and mycoplasmas . The potent in vitro activity and the results of preliminary pot tests indicated that the antibiotic is practicable as an agricultural antifungal agent. Obstet Gynecol, 1984 Dec, 64(6), 762 - 6 Piperacillin versus clindamycin plus gentamicin for pelvic infections; Gilstrap LC 3rd et al.; Piperacillin, a new semisynthetic penicillin, has broad spectrum activity against most clinically important aerobic and anaerobic bacteria . In the present study, piperacillin was compared with a combination of clindamycin and gentamicin for the treatment of 83 women with pelvic infection (42 with endometritis, 29 with posthysterectomy cuff infections, 11 with acute salpingitis, and one with a wound infection) . There were 179 bacterial isolates, 98 (53%) aerobic and 81 (45%) anaerobic . Of the 42 patients treated with piperacillin, there were three (7.1%) clinical failures compared with one (2.4%) in the 41 patients treated with clindamycin-gentamicin . A single drug, piperacillin, was shown to be as safe and effective as the combined clindamycin plus gentamicin therapy for pelvic infections. Chest, 1984 Dec, 86(6), 881 - 3 Pulmonary disposition of moxalactam; Braude AC et al.; Moxalactam is a new synthetic oxa-beta-lactam antibiotic with a broad spectrum of activity against Gram-positive and Gram-negative aerobic and anaerobic bacteria . It has proven clinical efficacy in pneumonia caused by a variety of infecting organisms . Therapeutic concentrations of moxalactam are achieved in most body tissues and fluids, including pleural fluid and sputum . However, assessment of the adequacy of lung tissue levels in pneumonia requires the sampling of material at an alveolar level . We performed bronchoalveolar lavage (BAL) in 13 patients one hour after they had been given moxalactam intravenously in doses ranging from 250 mg to 2 g . Absolute alveolar drug levels ranged from less than 1 to 6 micrograms/ml, and serum levels from 8 to 50 micrograms/ml . When expressed per micromole of creatinine, there was a significant relationship (r = 0.85; p less than 0.01) between serum and alveolar moxalactam levels in those patients in whom the drug concentration could be quantified accurately in BAL fluid. Obstet Gynecol, 1984 Dec, 64(6), 802 - 6 Placental microbiology and histology and the pathogenesis of chorioamnionitis; Pankuch GA et al.; The present study was undertaken to determine the proportion of cases of chorioamnionitis that was caused by microbiologic agents . Seventy-five placentas were processed to isolate aerobic and anaerobic bacteria and chlamydia . Results were correlated with the presence or absence of histologic and clinical chorioamnionitis . Bacteria were recovered from 72% (18 of 25) of placentas with histologic chorioamnionitis and from nine of 11 cases (82%) of clinical chorioamnionitis, all of which had histologic chorioamnionitis . Bacteria were recovered from only 15% (six of 39) of placentas without histologic chorioamnionitis . Nearly 50% of the bacteria recovered from placentas were anaerobes, often fastidious in their growth requirements . Often two to three such anaerobes were recovered from a placenta . Findings of the present study increase the possibility that bacteria are responsible for most cases of chorioamnionitis. Jpn J Antibiot, 1984 Dec, 37(12), 2478 - 94 {Clinical studies on sulbactam/cefoperazone in the field of obstetrics and gynecology}; Obata I et al.; Efficacy and safety of sulbactam/cefoperazone (SBT/CPZ) was studied on gynecological infections . The results obtained are as follows: In the treatment of 31 cases of gynecological infections, the clinical efficacy of SBT/CPZ was assessed as excellent in 9 cases and effective in 22 cases . As for the bacteriological effects of SBT/CPZ, clinically isolated organisms were completely (100%) eradicated . In comparison with MICs of CPZ, SBT/CPZ was found to show a combined effect on Gram-negative and Gram-positive organisms in the order mentioned, but this effect was not observed against anaerobes . The combined effect of SBT/CPZ on beta-lactamase producing bacteria was also investigated in the same manner . As a result, SBT/CPZ was found to exert a combined effect on beta-lactamase strains of S . aureus, S . epidermidis, E . coli, B . catarrhalis and B . fragilis . The laboratory tests performed before and after administration of SBT/CPZ revealed rise in GOT and GPT values in 1 case, GPT values in 2 cases and eosinophil in 1 case . However, these rises were all mild and required no particular measures. Jpn J Antibiot, 1984 Dec, 37(12), 2338 - 42 {Fundamental and clinical evaluation of ceftriaxone in the field of obstetrics and gynecology}; Kuwabara M et al.; Ceftriaxone (Ro 13-9904, CTRX), a newly developed third-generation cephem antibiotic, reportedly has an antibacterial spectrum of wide-range and shows a much greater activity than cefazolin especially against Gram-negative bacteria and satisfactory effectiveness against anaerobes . In the gyneco-obstetric infections, the relation between the level in the intrapelvic organs and MIC is an important subject in many respects . The levels in the blood and each tissue determined in 54 cases, as presented in Fig . 2, show that a high concentration can be maintained for a long time . In particular the half-life time in the uterine artery and cubital vein was 8.2 hours and 7.8 hours, respectively, which was longer than that of any other existing antibiotics . This fact suggests that CTRX exhibits sufficient efficacy when administered intravenously even in a small dosage of 1 g in the present study . The clinical efficacy was good or above in all the 7 cases treated . There was neither clinical adverse reaction nor laboratory test abnormality found during and after the administration in any of the 54 cases in the fundamental study and 7 cases in the clinical study . It is suggested from the above-mentioned results that CTRX is an unprecedentedly useful antibiotic with an antibacterial spectrum of wide-range. J Clin Microbiol, 1984 Nov, 20(5), 912 - 6 Determination of susceptibility of anaerobic bacteria to cefotetan and cefoxitin by the thioglycolate disk elution method; Barry AL et al.; The in vitro activities of two cephamycins, cefotetan and cefoxitin, against 107 anaerobic bacteria were evaluated . The aerobically incubated thioglycolate disk elution technique of Kurzynski et al . (Antimicrob . Agents Chemother . 10:727-732, 1976) was also evaluated to establish the appropriate number of 30-micrograms disks to be added to each tube, assuming that strains with MICs of less than or equal to 16 micrograms/ml are susceptible . Optimal predictive values were obtained when two tubes were prepared for each antimicrobial agent, one with two 30-micrograms disks and the other with three 30-micrograms disks . After 48 h of incubation, resistant strains grew in both tubes and susceptible strains provided no growth or growth less than or equal to 50% of that in the control broth . Growth in one tube but not in the other was considered an equivocal test result indicating the need for additional tests; 5 to 7% of our strains gave equivocal results . Reproducibility studies confirmed that broth microdilution tests were more reproducible than disk elution susceptibility tests. J Infect Dis, 1984 Nov, 150(5), 623 - 30 Treatment of serious gram-negative infections with aztreonam; Greenberg RN et al.; Aztreonam (SQ 26,776) is the first parenteral monobactam agent to be used in patient trials . The agent has significant activity in vitro against facultative aerobic gram-negative bacteria but not against gram-positive or anaerobic bacteria . Aztreonam was used for a year to treat 106 hospitalized patients with a total of 131 documented gram-negative infections . Important exclusion criteria included granulocytopenia, hyperbilirubinemia, meningitis, patients less than 13 years of age, pregnancy, and history of anaphylaxis to penicillin . In this study of 35 men and 71 women, there were 67 cases of pyelonephritis (25% bacteremic), 19 of pneumonia (16% bacteremic), 10 of skin or soft-tissue infections, 9 cases of osteomyelitis, and 6 cases of postpartum endometritis . During the study period, 159 facultative aerobic gram-negative bacteria were tested for aztreonam susceptibility, and 144 (91%) were found to be susceptible . Eighty percent of infections were cured by both clinical and microbiological criteria and each of the other 26 infections showed clinical improvement . Eradication of the infecting organism was achieved in 89% of infections without adverse reaction or drug toxicity. Infection, 1984 Nov-Dec, 12(6), 395 - 401 Identification and susceptibility patterns of anaerobic bacteria isolated from clinical specimens during a one-year period; Rodloff AC et al.; During the whole of 1983, all anaerobes cultured from clinical specimens were identified using both the Minitek system and gas chromatography . Antimicrobial susceptibility patterns were established using a broth microdilution test . The results show isolation rates for the individual species to be in good agreement with previous studies . Despite widespread use (even for prophylactic purposes), mezlocillin, latamoxef, cefoxitin, metronidazole and clindamycin retained their high activity against anaerobic bacteria and no clusters of resistance were observed . Augmentan also showed excellent in vitro activity . Penicillin was found to be inactive against most gram-negative anaerobic rods while tetracycline showed a rather high degree of resistance. Ann Surg, 1984 Nov, 200(5), 576 - 81 The bacteriology and septic complication of patients with appendicitis; Lau WY et al.; A detailed bacteriologic study was done on 161 patients operated for appendicitis . Aerobic and anaerobic cultures were taken from the blood, the appendicular lumen, mucosa, serosa, fossa, and from the wound after closure of the peritoneum . There is no correlation between the degree of appendicitis and the incidence of positive blood culture . The infection spread through the appendicular wall as the disease progressed . Aerobic infection was common in early appendicitis but a mixed aerobic and anaerobic infection was predominant in late cases . Late appendicitis, a positive wound culture at the end of the operation, the duration of symptoms of over 36 hours before operation and the age of the patient over 50 years were all associated with an increased incidence of septic complication . From the antibiotic sensitivity on the bacteria isolated, the most effective agent against anaerobes was metronidazole . Effective agents against the aerobes were aminoglycosides and cephalosporins . The best single agent against both anaerobes and aerobes was moxalactum. Acta Otolaryngol, 1984 Nov-Dec, 98(5-6), 556 - 9 Quantitative measurement of beta lactamase in tonsils of children with recurrent tonsillitis; Brook I et al.; Tonsils were obtained from 50 children suffering from recurrent tonsillitis . The tonsils' core material was cultured for aerobic and anaerobic microorganisms . Beta lactamase production was assayed in all isolates and beta lactamase activity was measured in the contents of each tonsil . Mixed aerobic and anaerobic flora was obtained in all patients, yielding an average of 7.9 isolates (4.4 anaerobes and 3.5 aerobes) per specimen . Beta lactamase production was noted in 58 isolates recovered from 39 tonsils (78%) . These were all 21 isolates of S . aureus and 10 B . fragilis, 18 of 45 B . melaninogenicus (40%), 7 of 14 B . oralis (50%), and 2 of 13 H . influenzae type B (15%) . Beta lactamase activity was detected in 33 of the 39 (85%) tonsils which harbored beta lactamase-producing bacteria, and in none of the 11 tonsils which had no beta lactamase-producing bacteria . Our findings indicate the polymicrobial nature of deep tonsillar flora in children with recurrent tonsillitis, and demonstrate the presence of detectable beta lactamase activity in the tonsillar tissue in most of the tonsils which harbored beta lactamase-producing organism. J Am Dent Assoc, 1984 Nov, 109(5), 712 - 6 Contamination of dental unit cooling water with oral microorganisms and its prevention; Bagga BS et al.; Each time the handpiece turbine is stopped while the bur is still in the patient's mouth, almost 1 ml of microbe-laden oral fluids may be aspirated into the average dental unit water line by the retraction valve present in the dental unit . This fluid may contain an average in excess of 54,000 microorganisms per milliliter, including both facultative and obligate anaerobic bacteria of medium to high virulence . Other infectious agents including hepatitis, herpes, influenza, and other upper respiratory viruses may also be present . This germ-laden water may then be sprayed into the mouth of the next patient, possibly initiating an oral or upper respiratory tract infection . Sterilizing the handpiece between appointments, although of great significance in the prevention of disease transmission, will not totally eliminate the problem discussed here as almost 95% of the oral fluid aspirated into the dental unit went past the handpiece and into the handpiece cooling water line . Complete elimination of the retraction valve in the unit is the most effective means of solving this problem, but, with present dental unit designs, this may result in water dripping onto the patient . A viable alternative is the installation of a check valve (anti-retraction valve) downstream from the retraction valve . Installation of a check valve resulted in an almost 4,000-fold decrease in this contamination . The attachment of a check valve will have no effect on normal less virulent bacteria already present in tap water . These bacteria colonize the water lines of the dental unit and are then continually shed into the water in numbers often as high as 1,000,000 CFU/ml.(ABSTRACT TRUNCATED AT 250 WORDS) Arch Otolaryngol, 1984 Nov, 110(11), 752 - 4 Eikenella corrodens . An emerging pathogen in head and neck infections; Tami TA et al.; Eikenella corrodens is a gram-negative, facultative anaerobe that exists as part of the normal oral flora . Its role as a pathogen in human infection has been disputed, but recently its pathogenic potential has been increasingly recognized . A review of the literature reveals the emergence of this organism as a pathogen in human infection . Specific microbiologic characteristics of this organism make it difficult to isolate and evaluate for antibiotic sensitivities . Infections produced by this bacteria are characteristically indolent in nature and are usually associated with oral contamination . Appropriate antibiotic therapy utilizes ampicillin or penicillin . Tetracycline is the drug of choice in the penicillin-allergic patient . Clindamycin resistance is a universal feature . A greater awareness of the pathogenic potential of E corrodens is essential for appropriate recognition and treatment. Jpn J Antibiot, 1984 Nov, 37(11), 2234 - 42 {Fundamental and clinical studies of sulbactam/cefoperazone in obstetrics and gynecology}; Kubota K; The study was done to evaluate the usefulness of sulbactam/cefoperazone (SBT/CPZ) injection for the treatment of infections in the field of obstetrics and gynecology . Fundamental and clinical studies were made and the following results were obtained . In the clinical studies, SBT/CPZ was given to 19 cases with female genital organ infections . As for the clinical effects, responses were excellent in 4 cases, good in 15 cases among 19 cases in total . The efficacy rate was 100% . The efficacy rate on disease was 100% in all cases (9 cases of puerperal uterine infection, 1 case of endometritis, 1 case of pyometra, 5 cases of adnexitis, 2 cases of pelveoperitonitis and 1 case of abscess of vulva) . As for causative bacteria, the efficacy rate was 100% for all infections due to single or mixed infection, due to aerobic Gram-negative, -positive or anaerobic bacteria . Side effect was observed in 1 case with diarrhea . SBT/CPZ showed a satisfactory clinical efficacy and a potent bacteriological effect in treatment of the infection in the field of obstetrics and gynecology, and it has been concluded that SBT/CPZ will be a useful addition to the antibiotics for the therapy of these infections. J Clin Microbiol, 1984 Oct, 20(4), 826 - 7 Nitrocellulose filter blots for species identification of Mobiluncus curtisii and Mobiluncus mulieris; Roberts MC et al.; Seventy strains of Mobiluncus, motile curved anaerobic bacteria associated with bacterial vaginosis, were correctly identified to species level by using bacteria fixed to nitrocellulose and hybridized with 32P-labeled DNA. Sex Transm Dis, 1984 Oct-Dec, 11(4 Suppl), 430 - 1 Susceptibility of anaerobic bacteria to thiamphenicol; Finegold SM; The activity of thiamphenicol, an analogue of chloramphenicol without a nitro group, was compared with that of chloramphenicol against anaerobic bacteria . A plate dilution technique on brucella agar supplemented with laked sheep blood and vitamin K1 was used . Chloramphenicol exhibited slightly greater activity than thiamphenicol in vitro, but the difference was too small to be of potential clinical significance. Antimicrob Agents Chemother, 1984 Oct, 26(4), 601 - 3 Evaluation of two broth disk methods for antibiotic susceptibility testing of anaerobes; Helstad AG et al.; We evaluated the aerobic thioglycolate broth disk and the vaspar overlay broth disk methods for antibiotic susceptibility testing of 144 strains of anaerobes . For penicillin, carbenicillin, chloramphenicol, and metrionidazale, both broth disk methods yielded at least 95% agreement with results obtained by the National Committee for Clinical Laboratory Standards reference agar dilution procedure . For cefoxitin and clindamycin, the agreement was ca . 90% . Overall, the aerobic thioglycolate broth disk and vaspar overlay broth disk methods yielded agreements of 93.3 and 93%, respectively, with the National Committee for Clinical Laboratory Standards method. J Clin Microbiol, 1984 Oct, 20(4), 668 - 71 Laboratory experience with radiometric detection of bacteremia with three culture media; Wicher K et al.; In two long-term studies, the BACTEC radiometric system for detection of bacteremia was evaluated with three culture media each: (i) BACTEC media 6A (for aerobes) and 7B (for anaerobes) plus a thioglycolate medium and (ii) BACTEC media 6A, 7B, and 8A (hypertonic) . In study 1, clinically significant isolates were identified in 1,873 (13.9%) of 13,432 blood cultures with all three media . The thioglycolate medium revealed 143 (1.1%) organisms not recovered from the 6A and 7B media . In study 2, isolates were identified in 1,135 (12.9%) of 8,759 cultures with all three media; 104 (1.2%) organisms were isolated only from the hypertonic medium . The increased yield of positive cultures in the three-medium system is likely due to the larger volume of blood cultured. Microbiol Sci, 1984 Oct, 1(7), 175 - 8 Regulation of aerobic and anaerobic metabolism in facultative anaerobes: a role for cytochrome a1; Keevil CW; Despite extensive documentation, the regulatory effects of oxygen on protein synthesis are poorly understood . Oxygen either functions directly or indirectly, through changes in Eh or respiratory activity, or by interacting with a sensor molecule analogous to the lac repressor . Cytochrome a1, hitherto of unknown function in most bacteria, is proposed as the likely sensor. Chemioterapia, 1984 Oct, 3(5), 305 - 9 Comparative pharmacokinetic evaluation of ceftriaxone and cefotaxime in coincidence for short-term antimicrobial prophylaxis in surgery; Periti P et al.; In 48 patients undergoing elective gynecological, urological and otorhinolaryngological surgery a pharmacokinetic study after 1 g dose of ceftriaxone or cefotaxime was done . Concentrations of the two antibiotics were studied in interstitial fluid with the suction blister technique and in some tissues collected during the operation . The mean tissue levels were generally higher after ceftriaxone administration than after cefotaxime and for both drugs they were lower than the contemporary drug levels in interstitial fluid . However at the concentrations found almost all aerobic and anaerobic bacteria causing postoperative wound infections are inhibited. Toxicol Appl Pharmacol, 1984 Sep 30, 75(3), 547 - 53 Influence of dietary pectin on intestinal microfloral metabolism and toxicity of nitrobenzene; Goldstein RS et al.; Intestinal microfloral metabolism of nitrobenzene is essential for the production of methemoglobin . Since dietary pectin alters intestinal microflora, these studies were designed to examine the effects of dietary pectin on nitrobenzene-induced methemoglobinemia . Male Fischer-344 rats were fed either AIN-76A (purified diet containing 5% cellulose), AIN-76A with 5% pectin replacing the cellulose, or NIH-07 (cereal-based diet containing 8.4% pectin) for 28 days . Following this period, nitrobenzene (200 mg/kg) was administered by gastric intubation, and methemoglobin concentrations were determined after 1, 2, 4, 8, and 24 hr . Nitrobenzene-induced methemoglobinemia was evident as early as 1 hr, peaked at 4 hr, and diminished thereafter in rats fed NIH-07 diet . In contrast, nitrobenzene-induced methemoglobinemia was not detectable in rats fed AIN-76A; however, inclusion of 5% pectin in this diet resulted in methemoglobinemia comparable to that of NIH-07-fed animals at 4, 8, and 24 hr . Administration of 400 or 600 mg/kg nitrobenzene resulted in significant diet-related differences in methemoglobinemia . Administration of 600 mg/kg nitrobenzene to animals fed NIH-07 resulted in the highest methemoglobin concentrations (64 +/- 1%); those fed AIN-76A had the lowest (20 +/- 5%), and those fed AIN-76A containing pectin had intermediate methemoglobin concentrations (44 +/- 6%) . No diet-related differences in the microbial population of the stomach or small intestine were observed . However, the number of anaerobes present in the ceca of rats fed AIN-76A containing pectin was 2 to 2.5 times greater than that of rats fed AIN-76A . In vitro reductive metabolism of {14C}nitrobenzene was significantly greater in the cecal contents of rats fed NIH-07 than that in the cecal contents of either of the groups fed the AIN-76A-based diets . These studies indicate that intestinal microfloral metabolism and red blood cell toxicity of nitrobenzene is markedly different in animals fed cereal-based versus purified diets . Furthermore, since inclusion of pectin into the purified diet diminishes the magnitude of these effects, differences in dietary composition of fermentable carbohydrates in cereal-based and purified diets may mediate differences in metabolism and toxicity of nitrobenzene. Can Med Assoc J, 1984 Sep 15, 131(6), 605 - 7 Successful antimicrobial therapy of hepatic, intra-abdominal and intrapelvic abscesses; Ralph ED; Antimicrobial therapy without surgical drainage or therapeutic aspiration was effective in the management of four patients with deep abscesses ranging in diameter from 1.3 to 10.0 cm . Two of the patients had multiple hepatic abscesses, one had hepatic, intra-abdominal and intrapelvic abscesses, and one had an intrapelvic abscess alone . Anaerobic bacteria were isolated from the blood or abscesses in all four patients, and an aerobic-anaerobic infection was present in one patient . The patients were treated with metronidazole, alone or in combination with other antibiotics, for 3 to 6 weeks . Therefore, in selected patients with deep abscesses, a therapeutic trial of antimicrobial agents instead of surgery may be justified. Antimicrob Agents Chemother, 1984 Sep, 26(3), 394 - 400 Production, purification, and characterization of chandramycin, a polypeptide antibiotic from Streptomyces lydicus; Singh SK et al.; A plant pathogenic actinomycete identified as Streptomyces lydicus was isolated from the deep-pitted scab lesions of potato tubers . This strain produces a new polypeptide antibiotic named chandramycin . The antibiotic was isolated from culture broth by extraction with organic solvents and purified by chromatography . The purified antibiotic is a light-yellow crystalline compound soluble in water and in most organic solvents . Amino acid analysis of the acid hydrolysates of chandramycin revealed the presence of glycine, cis-methyl proline, valine, beta, beta-dimethylaminobutyric acid, beta-methyl-phenylalanine, and beta-2-thioazolyl-beta-alanine . The amino acid composition of chandramycin is qualitatively similar to that of a known antibiotic, bottromycin A2 . Chandramycin showed activity against several gram-positive and a few gram-negative species of bacteria . It showed a strong activity against anaerobic microorganisms . Oral doses of antibiotic when administered up to 466 mg/kg of body weight failed to produce any observable toxic effect in mice. Jpn J Antibiot, 1984 Sep, 37(9), 1607 - 19 {Study of cefoperazone in the field of obstetrics and gynecology . Susceptibility of clinical isolates to cefoperazone and cefoperazone concentrations in the exudate of the pelvic dead space}; Cho N et al.; As indexes for administration of cefoperazone (CPZ) in the treatment of gyneco-obstetrical infections, sensitivities to CPZ of important pathogenic organisms and CPZ concentrations in the exudate of the pelvic dead space were determined, and a pharmacokinetic analysis was made on the results . Sensitivities to CPZ were determined for freshly isolated organisms from gynecological material consisting of 227 strains of 7 aerobic bacteria and 70 strains of 1 anaerobic bacterium, in a total of 297 strains . MIC80 values of CPZ against E . coli, K . pneumoniae, P . aeruginosa, E . cloacae, C . freundii, S . aureus, S . epidermidis and B . fragilis were 0.39, 0.78, 6.25, 25, 50, 12.5, 12.5 micrograms/ml and 6.25 micrograms/ml, respectively . On the whole, these activities are relatively superior to those of other antibiotics . CPZ concentrations in the exudate of the pelvic dead space and their changes with time after 2 g single dose by drip infusion were Cmax 93.89 micrograms/ml, Tmax 1.53 hours, T 1/2 4.33 hours and AUC 759.4 hr X micrograms/ml . After 1 g single dose, they were Cmax 37.7 micrograms/ml, Tmax 3.2 hours, T 1/2 2.78 hours and AUC 339.2 hr X micrograms/ml . Similarly, after 2 g single dose intravenously, they were Cmax 111.02 micrograms/ml, Tmax 0.761 hours, T 1/2 6.22 hours and AUC 1,083.9 hr X micrograms/ml, and after 1 g single dose, they were Cmax 29.1 micrograms/ml, Tmax 2.65 hours, T 1/2 4.82 hours and AUC 296.9 hr X micrograms/ml . Similarly, after 2 g single dose intramuscularly, they were 39.4 micrograms/ml, Tmax 2.70 hours, T 1/2 8.19 hours and AUC 584.7 hr X micrograms/ml, and after 1 g single dose, they were Cmax 26.4 micrograms/ml, Tmax 5.79 hours, T 1/2 5.53 hours and AUC 435.7 hr X micrograms/ml . As indicated, there were noted dose-dependent responses and the kinetics of CPZ exudate concentrations varied with the administration routes . Whatever the dose level and the administration route were, CPZ exudate concentrations covered MIC80 values against important clinical isolates for 10 to 12 hours . This suggests that we can well expect of the antibacterial activity of this drug by any of these administration routes and dosages on the intrapelvic lesions. Mikrobiologiia, 1984 Sep-Oct, 53(5), 738 - 43 {Batch cultures of Escherichia coli with added substrate under various aeration conditions}; Smirnova GV et al.; The growth parameters (Xmax, Y, mu) of Escherichia coli batch cultures were studied when a substrate was added under different aeration conditions . If the pH was not adjusted, the bacterial growth stopped at pH 4.5 under the aerobic conditions or at pH 5.8 under the anaerobic conditions . When the pH 7.0 was constantly maintained, the accumulation of acid products in the aerobic culture was 3 times as high as in the anaerobic culture by the time the growth ceased . The anaerobic culture resumed its growth upon aeration . A hypothesis is proposed to explain the data. Am Rev Respir Dis, 1984 Sep, 130(3), 510 - 3 Septic pulmonary emboli secondary to internal jugular vein phlebitis (postanginal sepsis) caused by Eikenella corrodens; Celikel TH et al.; Postanginal sepsis is the term used to describe the life-threatening infection caused by suppurative phlebitis of the internal jugular vein secondary to infection of the parapharyngeal spaces . This begins with a history of pharyngitis followed by infection of the parapharyngeal spaces, septic pulmonary embolism, and septicemia caused by hematogenous dissemination of the infection . The oral anaerobes are the most common pathogens associated with this syndrome . Recently, we managed 2 patients who had septic pulmonary embolism from postanginal sepsis syndrome caused by Eikenella corrodens . Previously, E . corrodens has not been described in association with this syndrome . The clinical presentation, anatomic, bacteriologic, and management aspects of postanginal sepsis syndrome are reviewed based on our experience with these 2 cases . In patients with clinical evidence of septic pulmonary embolism, particularly in the nonintravenous drug abusers, postanginal sepsis and septic jugular phlebitis have to be considered as a source of septic pulmonary embolism. Mol Biochem Parasitol, 1984 Sep, 13(1), 1 - 12 Thiol groups on the surface of anaerobic parasitic protozoa; Gillin FD et al.; Evidence is presented that Giardia lamblia and Entamoeba histolytica, phylogenetically unrelated aerotolerant anaerobes, have crucial thiol groups on or easily accessible to their external surface . Both parasites were killed by three structurally unrelated thiol-blocking reagents which penetrate intact cells poorly or not at all . The parasites were protected from p-chloromercuribenzenesulfonic acid (10-100 microM) by cysteine or by reduced glutathione . Killing was arrested with identical kinetics by addition of either cysteine (which quickly penetrates the cells) or bovine serum albumin (which does not penetrate intact cells) at various times after p-chloromercuribenzenesulfonic acid, indicating that the reactive site may be on the outer surface of the cell . Proteins lacking cysteine did not protect . Sensitivity of three other protozoa to p-chloromercuribenzenesulfonic acid was also tested . Trichomonas vaginalis (anaerobic) was at least as sensitive as E . histolytica and G . lamblia, while Crithidia fasciculata and Paramecium tetraurelia (both aerobic) were less sensitive . Thiol groups on the G . lamblia surface were demonstrated directly by fluorescence-activated cell sorter analysis of trophozoites which had been modified with a thiol-specific hapten, N-iodoacetyl-N'-(5-sulfonic-1-naphthyl)ethylenediamine and reacted with fluorescent antibody to this hapten. J Antimicrob Chemother, 1984 Sep, 14 Suppl B, 285 - 9 Cefotaxime in caesarian sections in patients with chorioamniotitis; Sangaret AM et al.; Fifty women who had Caesarian section in the presence of chorioamniotitis due to mixed aerobic and anaerobic bacteria were treated with cefotaxime 4 g daily . There was complete recovery in 96% of cases. Biochem Biophys Res Commun, 1984 Aug 30, 123(1), 262 - 70 Metabolism of nitropolycyclic aromatic hydrocarbons by human intestinal microflora; Cerniglia CE et al.; Anaerobic bacterial suspensions from human and rat feces and intestinal contents, and pure cultures of anaerobic bacteria metabolized 1-nitropyrene and 6-nitrobenzo{a}pyrene to 1-aminopyrene and 6-aminobenzo{a}pyrene, respectively . The metabolites were isolated by reversed-phase high performance liquid chromatography and identified by comparison of their chromatographic and mass spectral properties with those of authentic compounds . The results suggest that anaerobic intestinal bacteria could play a significant role in the metabolism of potentially carcinogenic nitropolycyclic aromatic hydrocarbons. Laryngoscope, 1984 Aug, 94(8), 1050 - 9 Visual loss associated with orbital and sinus diseases; Maniglia AJ et al.; Visual loss associated with orbital and sinuses diseases is mainly due to infectious processes, trauma and neoplasm . From 1975 to 1983, we have encountered 34 such cases . The most common cause in our series was infectious processes, either due to aerobic or anaerobic bacteria or fungi (aspergillosis and phycomycosis) . Iatrogenic trauma resulting in complete unilateral irreversible blindness was the second most common etiology in the series of cases that came to our attention for several reasons . Three of our patients with complete blindness, even with documented absence of light perception, secondary to infections or mucocele, underwent emergency surgical treatment with successful restoration of vision . Other patients with various degrees of visual loss experienced improvement, often to normal levels, when timely appropriate surgical treatment was applied . Orbital or optic nerve decompression was used according to pathologic findings encountered . High resolution CT scan has been very helpful in precisely pinpointing the lesion . It is also indispensable in the follow-up of orbital abscesses in order to rule out intracranial complications . Blindness with immediate onset secondary to either external or iatrogenic trauma, with rare exceptions, has a dismal prognosis . Early diagnosis and prompt treatment are essential for salvage of vision or even lives of patients affected by such dreadful complications. Gut, 1984 Aug, 25(8), 839 - 45 Is raised breath hydrogen related to the pathogenesis of pneumatosis coli? Read NW, Al-Janabi MN, Cann PA. Clinical and physiological studies were carried out in five patients with pneumatosis coli in order to investigate the origin of the high fasting breath hydrogen concentration in this condition and to determine its possible significance in the pathogenesis of the disease . All five patients excreted abnormally high fasting concentrations of hydrogen in their breath (69 +/- 9 ppm, mean +/- SEM) . Moreover, analysis of the contents of the gas filled cysts revealed between 2% and 8% of hydrogen gas . Colonic washout significantly reduced breath hydrogen concentrations to 9 +/- 6 ppm, but did not abolish the cysts . Conversely, deflation of the cysts was achieved with oxygen or antibiotics, though this only reduced breath hydrogen concentrations to about 66% of their original value . After feeding a radiolabelled meal, breath hydrogen concentrations rose before the meal appeared to reach the colon, suggesting overgrowth of anaerobic bacteria in the small intestine . Despite this, 14C glycocholate breath tests were within normal limits . An alternative possibility is that the high levels of hydrogen excreted in the breath may be produced in the intestinal lumen possibly from the fermentation of copious amounts of colonic mucus . Finally, measurement of whole gut transit time and stool weight suggested that patients were constipated despite passing mucus and blood . The relevance of our observations to the pathogenesis of submucosal cysts is unclear, but the data favour the hypothesis that these are produced by invasion of the colonic submucosa with anaerobic bacteria. Chemioterapia, 1984 Aug, 3(4), 242 - 5 Resistance to inactivating bacterial enzymes of different cephalosporins and in vitro activity; Ravizzola G et al.; The susceptibility in vitro of aerobic bacteria to cefoxitin and other cephalosporins was determined . The strains were isolated from clinical specimens during 1979 and 1983 . The in vitro activity of cefoxitin and other antibiotics against anaerobic bacteria was investigated . The resistance of 5 cephalosporins to inactivating enzymes of bacterial origin was compared. Immun Infekt, 1984 Aug, 12(4), 309 - 13 {Anaerobic bacterial meningitis with multiple brain abscesses}; Trautmann M et al.; The improvement of bacteriological techniques for isolation and identification of anaerobes has led to an increased interest in anaerobic infections . However, anaerobes have only rarely been found in cases of purulent meningitis, representing less than 1 percent of all isolated pathogens . We observed anaerobic meningitis in a patient suffering from multiple lung abscesses from which anaerobic bacteria spread to the brain, causing formation of anaerobic brain abscesses and consecutive meningitis . Microbiological examinations for anaerobes should be performed in those cases of meningitis in which purulent infections of other organs with known or suspected anaerobic etiology are present or in which a traumatic lesion of the subarachnoid space has preceded the development of meningitis. Oral Surg Oral Med Oral Pathol, 1984 Aug, 58(2), 152 - 5 A comparative study of the effectiveness of metronidazole and penicillin V in eliminating anaerobes from postextraction bacteremias; Head TW et al.; Recent reports have indicated the serious nature of anaerobic endocarditis and septicemia . As anaerobes can be isolated from postextraction bacteremias, this study was undertaken to evaluate the effectiveness of metronidazole and penicillin V in eliminating anaerobes from postextraction bacteremias . Twenty-five patients were randomly assigned to each of three groups--a placebo group, a metronidazole group, and a penicillin V group--for a total of seventy-five patients . Although penicillin V reduced the occurrence of anaerobes to a greater degree than did metronidazole, it was noted that gram-negative anaerobes were still detected in the blood of four patients in the penicillin V group . In the metronidazole group no gram-negative anaerobes were cultured . Because of the marked effectiveness of metronidazole against gram-negative anaerobes, the use of penicillin V and metronidazole in combination might be effective in the prevention of the sequelae of postextraction bacteremias . However, further studies, using a larger sample size, to investigate specifically gram-negative anaerobes are required. J Prosthet Dent, 1984 Aug, 52(2), 158 - 63 Sanitization of dentures by several denture hygiene methods; Moore TC et al.; Denture sanitization is an important element in the treatment of denture stomatitis and should be emphasized in instructions to patients . A two-part study was designed to compare the efficacy of eight denture-cleaning methods in removing and/or killing aerobes, anaerobes, and yeasts on dentures . Part I tested the effectiveness of the cleaners on a pure yeast culture of C . albicans . Part II tested the various denture sanitization techniques under actual clinical conditions . The following conclusions were made from the information obtained in this study: Miller's and Kleenite were the most effective sanitizing agents . Brushing the denture with soap and water and soaking the denture in the cleaner Mersene were effective to a lesser degree . Although Clorox and Calgon was effective at killing yeast under in vitro conditions, it was not effective under clinical conditions . The other denture cleaners were not found to be effective under the clinical conditions of this study for the removal and/or killing of any of the three microorganism groups cultured . In the past, the function of denture cleaners has been to remove deposits and stains from dentures . With the present knowledge of the role of microorganisms in the etiology of denture stomatitis, more emphasis should be placed on the ability of denture cleaners to sanitize dentures. Chirurg, 1984 Aug, 55(8), 519 - 22 {Perioperative prophylaxis in elective colorectal surgery}; Kujath P et al.; The effects of perioperative antibiotic prophylaxis in elective colon surgery was evaluated in a prospective study on 100 patients . Bowel cleansing was done by orthograde lavage . The patients were divided into 5 groups receiving equally cefotaxime 3 x 2 g, lamoxactam 3 x 2 g, cefmenoxime 3 x 1 g, mezlocillin 3 x 5 g an piperacillin 3 x 4 g . Mucosa biopsies of the resected colon were taken for aerobic and anaerobic cultures . Further mucosal serum probes were frozen immediately for determination of tissue and serum levels of the antibiotics . Our results show that bacterial growth of the colon mucosa was significantly reduced . Anaerobes were identified in only 8% . The tissue concentrations exceeded the MIC-levels of the identified bowel organisms many times over . The clinical infection rate was 4% . All administered antibiotics can be recommended without reservation. Surgery, 1984 Jul, 96(1), 42 - 7 The nipple valve as a sphincter substitute for the ileocecal valve: prevention of bacterial overgrowth in the small bowel; Myrvold H et al.; We evaluated the bacteriologic effect of a nipple valve substitute for the ileocecal valve in a canine model . Resection of the ileocecal valve and the distal 40% of the jejunoileum with end-to-end anastomosis was carried out in 10 dogs . In five of the dogs chosen randomly, a nipple valve was constructed at the anastomosis; in the remainder , a two-layer jejunocolostomy was formed . Microbiologic samples were taken at operation in the ascending colon and at three sites in the small intestine before resection and at reoperation 4 weeks later . These revealed a dramatic increase in anaerobic bacteria in the distal jejunum following jejunocolostomy without valve insertion but no increase following jejunocolostomy with nipple valve . There was a seven-log difference between the two groups in the mean anaerobic bacterial counts (P less than 0.05) measured 60 cm proximal to the anastomosis at the second operation . Results of aerobic cultures were similar but less dramatic . We conclude that construction of a nipple valve jejunocolostomy prevents anaerobic bacterial colonization of the proximal small bowel and may therefore be useful in the treatment or prevention of short bowel syndrome. Cutis, 1984 Jul, 34(1), 93 - 5 Necrotizing cellulitis of the scrotum: a new complication of heroin addiction; Alguire PC; A drug addict experienced a necrotizing cellulitis of his scrotum and medial thigh after an injection of heroin into his left femoral artery . It is proposed that the arterial injection was directly responsible for producing the low tissue oxygen tension necessary for the synergistic growth of aerobic and anaerobic bacteria responsible for skin necrosis . The patient responded to wide surgical debridement and antibiotic therapy . To the best of our knowledge, this is the first report of necrotizing cellulitis associated with the intra-arterial injection of heroin. J Antimicrob Chemother, 1984 Jul, 14(1), 31 - 9 Antibacterial activities of nitrothiazole derivatives; Hof H et al.; A new group of chemical agents with pronounced antibacterial activities is presented . Different nitrothiazole derivatives, but not all, exhibit antibacterial activities similar to that of niridazole (AmbilharR), a nitrothiazolyl-imidazolidinone . Certain aerobic bacteria are moderately susceptible to these agents . The efficacy of these agents is almost comparable to that of ampicillin and tetracyline . It is much better than the efficacy of nitrofuran derivatives, the nitroimidazole derivatives being inactive . The mode of action of the nitrothiazole derivatives is bactericidal . Against anaerobic bacteria the nitrothiazole derivatives are unique, since the extremely low MIC's are not approached by any other of the nitro-compounds nor by any other of the common antibiotics tested, such as clindamycin, ampicillin and tetracycline . It is suggested that the nitrogroup of the nitrothiazole ring moiety represents the chemical structure responsible for their excellent antibacterial activities. J Clin Microbiol, 1984 Jul, 20(1), 81 - 3 Evaluation of a microtiter system for identification of anaerobic bacteria; Savuto PS et al.; The Anaerobe Combo Panel (American MicroScan, Mahwah, N.J.) was evaluated for its ability to identify anaerobic bacteria . The frozen, 96-well panel utilizes 24 biochemical reactions and four antimicrobial agents for species identification . The Anaerobe Combo Panel was used to test 114 clinical isolates of strict anaerobes . Reactions were read after 48 h, and the results were compared with those obtained with the PRAS II system (Scott Laboratories, Inc., Fiskeville, R.I.) . Discrepancies between the two systems were resolved by gas-liquid chromatography . With the Anaerobe Combo Panel, 84% of the organisms were able to grow, and 89% of these were correctly identified to genus level and 78% to species level . The Anaerobe Combo Panel was easy to inoculate and read, but some of the reactions were difficult to interpret, and not all of the derived codes were found in the code book. J Appl Bacteriol, 1984 Jun, 56(3), 487 - 92 Changes in metabolism and cell size of the anaerobic bacterium Selenomonas ruminantium 0078A at the onset of growth in continuous culture; Silley P et al.; Initial metabolism of Selenomonas ruminantium 0078A in continuous culture was characterized by a high lactate and low volatile fatty acid production; this was associated with poor growth as determined by bacterial dry weight production, yet individual cells were considerably larger than those of the inoculum . Biomass production increased, cell size decreased and the fermentation pattern reverted to the characteristic low lactate and high volatile fatty acid production after approximately 90 h growth. Antimicrob Agents Chemother, 1984 Jun, 25(6), 764 - 6 Susceptibility of anaerobic bacteria from several French hospitals to three major antibiotics; Dubreuil L et al.; The in vitro activity of cefoxitin was compared with those of metronidazole and clindamycin against 322 strains of anaerobic bacteria collected from several hospitals during 1982 and tested by an agar dilution method . Metronidazole and cefoxitin inhibited at least 89% of strains tested, whereas clindamycin was less active. Infect Immun, 1984 Jun, 44(3), 650 - 2 Quantitative vaginal microflora in women convalescent from toxic shock syndrome and in healthy controls; Chow AW et al.; PIP: Sequential and quantitative vaginal cultures obtained from 8 women within 4 days-3 years (average, 15.8 months) after their recovery from classic menstrual toxic shock syndrome (TSS) and from 11 healthy women who served as age-matched controls were performed . Apart from tampon use, which was significantly less frequent in TSS women after their acute illness, no demographic differences were observed in the 2 groups . Significantly lower total (aerobic and anaerobic bacterial counts were found in TSS women than in healthy controls (P0.05, Mann-Whitney test) . These differences were most profound during the menstrual (aerobes) and premenstrual (aeobes and anaerobes) sample times, whereas no difference in bacterial counts was observed in the midcycle samples . Although the less frequent usage of tampons among TSS women after their acute illness might explain the lower aerobic counts in menstrual specimens, this is unlikely to explain the significantly lower aerobic and anaerobic counts observed in premenstrual samples when tampons were not used in either group . It is possible that these differences in the quantitative vaginal microflora were a direct result of recent TSS in these women . Alternatively, disruption of the normal indigenous microflora could have predisposed these women to acute TSS by alteration of the resistance of vaginal colonization to pathogenic microorganisms . author's modified Pathol Biol (Paris), 1984 Jun, 32(5 Pt 2), 591 - 5 {Effectiveness of 9 soaps and/or antiseptics on hand flora after surgical-type washing}; Reverdy ME et al.; We studied the effect of nine soaps and/or antiseptics on the bacterial flora of hands 5 minutes after a surgical scrub . Each agent was used by ten healthy volunteers, free of skin lesions . The following agents were used: chlorhexidine gluconate 4% and 1.5%, povidone iodine 4%, ethanol 70 degrees, isopropanol 70 degrees, a non-antiseptic soap, and another soap followed by either ethanol 70 degrees, isopropanol 70 degrees or a preparation containing H2O2 . The surgical scrub pr