Biochem Soc Symp, 1983, 48, 147 - 72 Anaerobic fermentations--some new possibilities; Morris JG; Anaerobic fermentations start with the major advantage that, unlike aerobic processes, they do not incur the cost penalties associated with the need to sustain high rates of culture aeration, agitation and cooling . Even so, many of the more traditional fermentations that yield high volume, low value products (such as alcohols or fatty acids) are currently only economically viable if they utilize biological wastes and agricultural surpluses as substrates . To achieve maximum conversion efficiency it is necessary to select the appropriate species/strain of micro-organism which will perform best under the intended conditions of operation (which could include elevated temperatures and extremes of pH) . Knowledge of the mechanisms whereby the fermentation is physiologically controlled can then suggest means, including genetically engineered strain improvements and/or the establishment of stable co-cultures with other microbes, whereby the yield of a desired product can be optimized . The biology of a fermentation process can thus be rendered sufficiently consistent and predictable for the biochemical engineer to be able to achieve optimal fermenter productivity . Anaerobic processes are particularly well suited to a continuous flow mode of operation (with cell retention) and new techniques for selective product removal and concentration can reduce the energy costs associated with 'downstream processing' . Hitherto, most interest has been centred on those anaerobic fermentations of renewable biomass which yield immediately useful products (fuel alcohols, methane) . However, by combining biological and chemical procedures the profitability of even some superficially unpromising fermentations could be substantially enhanced . Collaborative research by microbial physiologists, geneticists and biochemical engineers is a prerequisite for marketable success in new applications of fermentative anaerobes and their enzymes. Acta Chir Scand, 1983, 149(6), 573 - 8 Diffuse peritonitis treated with tobramycin and clindamycin . Bacteria in relation to preoperative duration of illness; Lindblad B et al.; Twenty consecutive patients, mean age 71 years, with a peroperative diagnosis of diffuse peritonitis were treated with clindamycin and tobramycin . The aim of this open prospective study was to correlate bacterial findings at operation to the duration of illness . The effectiveness of the treatment was also evaluated . The number of aerobic strains from peritoneal cultures outnumbered anaerobes when duration of illness was less than three days, while the opposite was evident when duration was longer . All isolates were fully susceptible to the antibiotic combination except for four anaerobic strains with MIC greater than 1 mg/l for clindamycin . The response to treatment was good in 18 patients, fair in one and poor in one. Scand J Infect Dis Suppl, 1983, 39, 86 - 91 Orofacial infections of odontogenic origin; Heimdahl A et al.; Purulent infections of the orofacial region are often of odontogenic origin . The clinical manifestations are largely dependent on the complex microbiota and the anatomical routes of spread . Serious complications may ensue, especially if hematogenous spread occurs . Direct invasion of different anatomical spaces may cause mediastinitis, airway obstruction and intracranial spread . Proper surgical treatment is mandatory to evacuate pus as soon as abscess formation is recognized . Anaerobic bacteria belonging to the normal oropharyngeal flora are usually isolated from these abscesses . The drug of choice for antimicrobial therapy is penicillin . However, antimicrobial treatment may have to be altered due to emergence of antimicrobial-resistant anaerobic bacteria. Scand J Gastroenterol Suppl, 1983, 85, 5 - 14 Diagnostic considerations and sample collection for anaerobic bacteria; Bergan T; Anaerobic bacteria are particularly frequent in infections following surgery and other trauma implanting bacteria of the normal mucosal flora . A few clinical clues of anerobic infections like smelling pus or discharge, preceeding aminoglycoside therapy or lack of anaerobic bacterial growth are important clues that anaerobes may be involved . Successful recovery of anaerobic bacteria, however, requires special techniques carried out by the clinician . Samples must be taken with a few basic rules in mind: (1) puncturing by syringe is the preferable method of sampling, (3) oxygen must not gain access to the samples (and must be removed before transport to the laboratory, if inadvertently admitted), (4) rapid transport to the laboratory improves the chance of successful recovery of anaerobes, and (5) special transport methods are required for specimens containing anaerobic bacteria. Acta Chir Scand, 1983, 149(4), 423 - 6 Comparison of cefuroxime and gentamicin in combination with metronidazole in the treatment of peritonitis due to perforation of the appendix; Saario I et al.; A study on 42 surgical patients was carried out to find out whether cefuroxime may be substituted for gentamicin in combination with metronidazole in the treatment of peritonitis secondary to perforation of appendix . All patients recovered and there were four wound infections in each group . Both aerobic and anaerobic bacteria were cultured in the peritoneal fluid in 69% of cases and anaerobes only in 19% of the patients . Postoperatively the patients were followed up for one month . The mean length of the hospital stay and convalescence did not differ significantly . There was also no difference in the time to the removal of gastric suction, laboratory measurements and the incidence of pyrexia between the study groups . Although the number of patients was limited the present study indicates that gentamicin may be replaced by less toxic cefuroxime . This is especially the case if there are several risk factors in the use of gentamicin and if there is not a possibility for monitoring the serum levels of gentamicin. Zentralbl Gynakol, 1983, 105(11), 720 - 5 {Prevention of preoperative infection with metronidazole}; Gobel G et al.; We practiced a preoperative prophylaxis with 1.5g metronidazole daily starting three days before operation because of the increasing knowledge about the importance of anaerobic microorganisms, causing nosocomial infections . By this regime we saw a significant decrease of postoperative morbidity, detected by means of postoperative febrile temperatures and laparotomy wound abscesses . Bacteriological examinations before and after prophylaxis revealed a relatively high elimination of anaerobic isolates without influence on the aerobic and physiologic flora . In 66% of the cases with infections we isolate anaerobic strains . In cases of pelvic inflammatory diseases metronidazole is to be recommended both prophylactically and therapeutically . There is no resistance against metronidazole. Ann Clin Res, 1983, 15(1), 15 - 20 A randomized evaluation of single dose chemoprophylaxis in elective colorectal surgery--a comparison between metronidazole and doxycycline; Solhaug JH et al.; In a prospective, randomized blind study either 400 mg doxycycline or 1500 mg metronidazole were given intravenously in a single preoperative dose to 147 consecutive patients before elective colorectal surgery . Septic complications mainly caused by a mixed flora of aerobes and anaerobes occurred in 13% of the patients in the doxycycline group . Septic complications occurred in 29% of the patients in the metronidazole group and were caused by E . coli and coliform rods . Bacteriological studies showed a marked reduction of anaerobes in peroperative samples in this group . Most postoperative infections were superficial and mild wound infections . The inactivity of metronidazole against aerobes resulted in an unacceptable high frequency of septic complications caused by aerobic bacteria . For chemoprophylaxis metronidazole should therefore be combined with an antimicrobial agent against aerobic bacteria. Zentralbl Gynakol, 1983, 105(4), 212 - 9 {The significance of laparoscopic examination in acute adnexitis for bacteriological diagnosis}; Kolmorgen K et al.; Cultures of abdominal bioptic material from 102 cases of acute pelvic inflammatory disease diagnosed laparoscopically revealed that anaerobes were involved in 42.2% of the cases; 18.6% of the cultures were sterile . There were no signs that anaerobes predominate in cases, in which an abscess has already formed . The proportion of predominantly polymicrobial multiple infections was 54.2%, the remaining 45.8% of the cases involving mono-microbial infection . Scrutiny of the abdominal and cervical distribution of the germs in 42 of our female patients confirmed that cervical smears are inadequate for detecting the causal germ involved in a case of acute pelvic laparoscopy it seems advisable to use abdominal cultures of tissue taken from the locality of the inflammation in order to identify exactly the causal germ and to test these cultures also for anaerobes and gonococci. Arch Intern Med, 1983 Jan, 143(1), 164 - 5 Polymicrobial anaerobic septicemia due to lateral sinus thrombophlebitis; Pallares R et al.; Continuous polymicrobial anaerobic septicemia was the main manifestation of a lateral sinus thrombophlebitis (LST) in a patient who had a history of chronic otitis media . Five different anaerobic microorganisms were isolated in blood cultures . Three of them were also present in ear cultures . The diagnosis was confirmed at surgery and the patient was successfully treated with moxalactam disodium therapy . This case emphasizes that LST should be considered before polymicrobial anaerobic septicemia, especially if there is a history of chronic otitis media. Lancet, 1983 Jan 1, 1(8314-5), 41 - 3 Successful substitution of rectal metronidazole administration for intravenous use; McLean A et al.; Wound infection and isolation of anaerobic organisms before and after intravenous and rectal administration of metronidazole were studied in 24 505 surgical patients . In the 6303 patients who underwent "risk" surgery (bowel, biliary, gynaecological, or otolaryngological surgery) introduction of intravenous metronidazole was associated with a striking fall in wound infection and wound anaerobe isolation rates; and the changes were maintained when the majority of metronidazole used was in suppository form . In the 18 202 patients who underwent "clean" surgery (e.g., orthopaedic, ophthalmic, and plastic surgery) metronidazole use was associated with a small formulation-independent change in infection rate without change in anaerobe isolation rates . Without compromising clinical care the use of intravenous metronidazole can be limited to a minority of patients with special needs. Biochim Biophys Acta, 1982 Dec 17, 719(3), 606 - 11 A novel iron protein from Desulfovibrio gigas; Smith AK et al.; The isolation, purification, and partial characterization of a novel iron-containing protein from the sulfate-reducing anaerobic bacterium, Desulfovibrio gigas, is described . The highly insoluble protein was isolated from the cell debris following osmotic shock of the bacteria . The insoluble fraction consistently contained about 90% of the cell-associated iron . Elemental analysis of a crude protein preparation gave 5.3% iron, 2.9% sulfur and 11.9% nitrogen . An independent colorimetric iron analysis showed 6.4% iron . The iron could be dissociated from the protein by treatment with 5% SDS . The iron-free protein was purified by a combination of organic extraction and DEAE-cellulose chromatography . The purified protein showed only one major band, Mr 14000, by SDS-polyacrylamide gel electrophoresis . The protein could be reconstituted upon treatment with an appropriate mixture of FeS and beta-mercaptoethanol . The reconstituted protein had the same physical and chemical properties as the native protein . The amino acid composition was not unusual except for the high isoleucine content. Steroids, 1982 Dec, 40(6), 701 - 11 The preparation of bile acid amides and oxazolines . II . The synthesis of the amides and oxazolines of ursodeoxycholic acid, deoxycholic acid, hyodeoxycholic acid and cholic acid; Cohen BI et al.; Bile acid amides and oxazolines were synthesized by a sequence of steps involving the reaction of the free bile acid with formic acid to yield the formyloxy derivative, preparation of the formyloxy acid chloride, condensation of the acid chloride with 2-amino-2-methyl-1-propanol to give the amide and, finally, cyclization of the amide with thionyl chloride to give the oxazoline . The oxazolines were characterized by physical constants, thin layer and gas-liquid chromatography and identified by elemental analysis and gas-liquid chromatography-mass spectrometry . Some of the bile acid oxazoline derivatives alter the activity of bacterial 7-dehydroxylases in vitro, and inhibit the growth of certain anaerobic bacteria in pure culture. Jpn J Antibiot, 1982 Dec, 35(12), 2761 - 7 {Clinical trial of cefoxitin used in the treatment of patients with cholesteatoma undergoing surgical procedures}; Morikawa K; Eleven patients with cholesteatoma undergoing surgical procedures were treated with cefoxitin . The following findings were obtained: 1 . Eight out of 11 patients' responses were judged "good" and the remaining 3 were judged "fair" with a cure rate of 72.7% . 2 . No untoward side effects and abnormalities in laboratory findings were noted on cefoxitin . 3 . Cefoxitin should be considered for the treatment of cholesteatoma undergoing surgical procedures because it is well tolerated, has a broad spectrum of antibacterial activity against both Gram-positive and Gram-negative pathogens including anaerobes. J Clin Microbiol, 1982 Dec, 16(6), 1152 - 4 Effect of incubation conditions on anaerobic susceptibility testing results; Murray PR et al.; We determined the effect of performing antimicrobial susceptibility tests in five different anaerobic incubation systems: GasPak jar, large GasPak jar, evacuated-gassed anaerobic jar, anaerobic chamber, and Bio-Bag . Growth of the anaerobes was equivalent in all five incubation systems . The results of testing 38 anaerobes against 11 antimicrobial agents were comparable for the anaerobic jars and anaerobic chamber . However, discordant results were observed for metronidazole and cefamandole tests when incubated in the Bio-Bag. J Clin Microbiol, 1982 Dec, 16(6), 1066 - 72 Comparison of media in the Anaerobe-Tek and Presumpto plate systems and evaluation of the Anaerobe-Tek system for identification of commonly encountered anaerobes; Lombard GL et al.; Using a variety of sporeforming and nonsporeforming anaerobic bacteria, we compared 10 differential agar media of the Anaerobe-Tek (A/T) system recently marketed by Flow Laboratories, Inc . (McLean, Va.) with 10 comparable media in Presumpto quadrant plates (Presumpto 1, 2, and 3) developed by the Centers for Disease Control Anaerobic Bacteria Branch . The A/T identification system was evaluated by comparing the species identity of anaerobes determined as recommended by the manufacturer's instruction manual with the identity of the strains obtained by the Centers for Disease Control Anaerobe Reference Laboratory by using conventional procedures . We also compared reactions obtained with the Presumpto plates with a chopped meat glucose broth culture as a source of inoculum with those obtained by using a turbid cell suspension from growth on blood agar as inoculum . The agreement of results for the 16 characteristics compared ranged from 92.8 to 100% . Comparison of test results obtained with 10 media in the Presumpto plate and A/T systems from the examination of 223 strains of anaerobes, representing 54 different taxa, showed the following agreement between A/T and CDC systems: catalase production, esculin hydrolysis, glucose fermentation, and lecithinase production (100%); inhibition of growth by bile agar (99.6%); lipase production (99%); DNase (98.7%); fermentation of lactose and mannitol (98.2%); starch hydrolysis (96.9%); gelatin hydrolysis (96.4%); and casein hydrolysis (94.6%) . Of the 204 strains of common anaerobes tested with the A/T system, only 70% were correctly identified to the species level . However, several strains could have been identified correctly with the A/T system if data on certain other characteristics had been included in the A/T data base. Antibiotiki, 1982 Nov, 27(11), 854 - 7 {Characteristics of clinical strains of anaerobic asporous microorganisms isolated from trauma and orthopedic patients and their antibiotic sensitivity}; Mel'nikova VM et al.; The procedure of and the data on the bacteriological investigation of the pathological material collected from 178 patients with purulent inflammatory diseases of various localization (mainly of the locomotor system) are presented . Obligate anaerobes were detected in the specimens of the clinical material from 39 per cent of the patients . Antibiotic sensitivity of 62 strains of the obligate anaerobic bacteria was determined . Of the antibiotics tested, levomycetin, carbenicillin and lincomycin proved to be most active against the anaerobes. Laryngoscope, 1982 Nov, 92(11), 1311 - 5 Anaerobic mastoiditis: a report of two cases with complications; Moloy PJ; Aerobic bacteria are responsible for most cases of suppurative otitis media/mastoiditis (OM/M) . As many as 20-30% of middle ear aspirates in acute otitis media, however, are reported to be sterile on aerobic culture . Some of these cases may be due to anaerobic bacteria . Two cases of OM/M due to anaerobic bacteria are reported . The first patient had no antecedent ear disease and developed a large Bezold abscess caused by Fusobacterium varium . The second patient had attic retraction pouches bilaterally and a history of otorrhea . This patient developed labyrinthitis and meningitis due to B . fragilis . The clinical progression of disease in both cases indicates that anaerobic OM/M can follow a deceptively asymptomatic course . By contrast, complications of OM/M occur abruptly and extend rapidly in a manner typical of acute aerobic disease . Both cases required surgery for cure. Rev Infect Dis, 1982 Nov-Dec, 4(6), 1133 - 53 Clindamycin: a review of fifteen years of experience; Dhawan VK et al.; Clindamycin, the 7(S)-chloro-7-deoxy derivative of lincomycin, has stood the test of time in the treatment of anaerobic infections . Clindamycin inhibits protein synthesis by acting on the 50S ribosomal subunits of bacteria . The colitis resulting from the use of clindamycin has been extensively studied and is now easily manageable . Although newer antibiotics active against anaerobes are available, clindamycin remains a reliable and well-tested antibiotic for use in anaerobic infections. Vestn Khir Im I I Grek, 1982 Nov, 129(11), 13 - 9 {Clinico-diagnostic value of the anaerobic method of study of the purulent foci in surgical patients}; Koroliuk AM et al.; The paper presents data of studying pyo-inflammatory diseases in 168 surgical patients . A large group of bacteria referred to strict anaerobes is shown to take part in pathogenesis of suppuration . These pathogenic agents are related with the appearance of 87% of hospital and endogenous infections and with the appearance of 39% of infections of the traumatic and other exogenous etiology . The aerobic infections made only 38% of the total amount of the patients examined, anaerobic infections made 16% . In the rest 46% of patients the diseases were of the mixed anaerobic-aerobic etiology. Dis Colon Rectum, 1982 Nov-Dec, 25(8), 783 - 6 Cephalothin, cefoxitin, or metronidazole in elective colonic surgery? A single-blind randomized trial; Panichi G et al.; A randomized controlled trial aimed at comparing the individual efficacy of cephalothin, cefoxitin, and metronidazole in the prevention of postoperative wound infection was performed among 74 colorectal surgical patients . Of 28 patients on cephalothin, seven (25 per cent) developed a postoperative infection, but among 23 patients in each of the other two groups, only one (4 per cent) in each group became infected . These results confirm the primary importance of anaerobes in the causation of postoperative sepsis after colorectal surgery. FEBS Lett, 1982 Nov 1, 148(1), 35 - 8 A biotin-dependent sodium pump: glutaconyl-CoA decarboxylase from Acidaminococcus fermentans; Buckel W et al.; The decarboxylation of glutaconyl-CoA to crotonyl-CoA in the anaerobic bacterium Acidaminococcus fermentans is catalysed by a membrane-bound, biotin-dependent enzyme which requires Na+ for activity . Inverted vesicles from A . fermentans accumulated Na+ only if glutaconyl-CoA was decarboxylated . The Na+ uptake was inhibited by avidin but not by the avidin biotin complex . Detergents and ionophores such as monensin also prevented the Na+ transport . The results indicate that the enzyme is able to convert the free energy of decarboxylation (delta Go' approximately equal to -30 kJ/mol) into a Na+ gradient. Rev Infect Dis, 1982 Nov-Dec, 4 Suppl, S610 - 6 Distribution of moxalactam in serum, bone, tissue fluid, and peritoneal fluid; Wittmann DH et al.; Concentration-vs.-time curves in serum, peritoneal fluid, bone, and tissue fluid were determined after 2-g intravenous doses of moxalactam . Serum concentrations were measured in five volunteers (group 1; mean age, 22.8 years) . Serum and peritoneal fluid concentrations were measured in eight patients (group 2; mean age, 66.5 years) . Serum, bone, and tissue fluid concentrations were measured in eight patients (group 3; mean age, 71.5 years) . The serum concentrations fitted an open two-compartment model . In groups 1, 2, and 3, the respective serum beta-phase half lives were 134, 169, and 184 min . In group 2, the peak concentration in peritoneal fluid was 43.8 mg/liter after 2.02 hr, with one-quarter of this concentration being maintained for 13 hr . In group 3, the bone concentrations were 19.4 mg/liter after 60 min and 19.1 mg/liter after 120 min; the peak concentration in tissue fluid was 36.1 mg/liter after 2.4 hr, with one-quarter of this concentration being maintained for 15 hr . These concentrations in tissues will inhibit most aerobic and anaerobic bacteria that cause infections. Br J Ind Med, 1982 Nov, 39(4), 392 - 6 Anaerobes: a new aetiology in cavitary pneumoconiosis; del Campo JM et al.; The role of mycobacteria in the cavitation of large pneumoconiotic masses is well established . In other cases softness is attributed to an ischaemic or aseptic necrosis . Five cases are described in which cavitation of the pulmonary masses was caused by anaerobic bacteria, confirmed by the growth of such bacterial in cultures after transtracheal or transpleural puncture . Repeated cultures for mycobacteria gave negative results . Two cases were acute, having serious complications such as bronchopleural fistula, empyema, and serious respiratory insufficiency . The role of anaerobes in cavitary pneumoconiosis has not been recognised previously, probably because of the special conditions required to culture these bacteria and the infrequent use of transtracheal puncture in the diagnosis of this entity . The prevalence of anaerobes as agents capable of cavitating pneumoconiotic masses remains to be established. Lancet, 1982 Oct 2, 2(8301), 753 - 5 Preoperative antimicrobial prescribing practice for elective colorectal surgery in Wessex, 1981; McDonald PJ et al.; 32 Wessex surgeons took part in a survey of preoperative antimicrobial prescribing practice for elective colorectal surgery . Only 1 surgeon did not prescribe antimicrobials . 15 (48%) of those surgeons giving antimicrobials used systemic antibiotics only, whilst 9 (29%) gave agents both systemically and orally . With 1 exception, all surgeons used an agent effective against anaerobes, whereas 27 (87%) used an agent or agents to cover both groups . All the surgeons started the antimicrobials before surgery, and half continued them for less than 48 h . Conventional bowel preparation was found to be the most popular method. Antimicrob Agents Chemother, 1982 Oct, 22(4), 711 - 4 In vitro activity of new beta-lactam antibiotics and other antimicrobial drugs against anaerobic isolates from obstetric and gynecological infections; Ohm-Smith MJ et al.; The in vitro activities of N-formimidoyl thienamycin, clindamycin, chloramphenicol, metronidazole, cefoperazone, cefotaxime, cefoxitin, moxalactam, penicillin G, and piperacillin were determined against 158 anaerobic bacteria isolated from endometrial wash cultures of women with pelvic infections . In general, N-formimidoyl thienamycin was the most active, with all organisms inhibited by less than or equal to 0.5 microgram/ml . Chloramphenicol, clindamycin, and metronidazole inhibited all organisms by less than or equal to 8 microgram/ml . The penicillins and cephalosporins exhibited variable activity of lesser degrees. Lab Anim, 1982 Oct, 16(4), 348 - 50 Response of mice to transtracheal pulmonary inoculation of anaerobic bacteria; File TM Jr et al.; The transtracheal inoculation of a mixture of anaerobic bacteria, with or without hydrochloric acid, into the lungs of mice caused nonlethal pneumonia and abscesses in a minority of challenged animals . All animals cleared organisms and recovered by 30 days . Secondary infection with Escherichia coli was common but did not affect the response to challenge with the anaerobes. Gut, 1982 Oct, 23(10), 807 - 13 Disposition of oral metronidazole in hepatic cirrhosis and in hepatosplenic schistosomiasis; Daneshmend TK et al.; The pharmacokinetics of metronidazole 500 mg orally were determined in patients with hepatosplenic schistosomiasis and normal controls in the Sudan, and in cirrhotics and normal controls in Bristol . Plasma metronidazole levels were above the minimum inhibitory concentration of most susceptible anaerobic bacteria for four to six hours post-dose in all groups . Liver disease did not markedly influence the disposition of single oral doses of metronidazole . Cirrhotics showed some prolongation of metronidazole half-life, and somewhat greater metronidazole concentrations 24 hours after the dose . Concentrations of the oxidative metabolite of metronidazole were lower in Sudanese patients and normal controls than in normal British subjects . In chronic liver disease adjustment of metronidazole dosage is probably not required provided renal function is unimpaired. J Clin Microbiol, 1982 Oct, 16(4), 673 - 5 Evaluation of the Minitek system for direct identification of anaerobic rods from positive blood cultures; Polomski JC et al.; The direct inoculation of the Minitek anaerobe identification system (BBL Microbiology Systems, Cockeysville, Md.) from positive blood cultures was compared with subculture and Minitek results obtained using the manufacturer's recommended procedures . A total of 40 clinical anaerobic blood cultures were processed for rapid identification utilizing bacterial pellets obtained by centrifugation . Of these cultures, 30 yielded pure isolates of anaerobic rods that were used for comparison . In 87% of the pure cultures, identification from the direct inoculum method was identical to the routine procedure using Minitek biochemicals . When the additional test for lecithinase and lipase production was included, the identification agreement was 97% . Direct identification of anaerobic rods from blood cultures utilizing the Minitek system is reliable, easy to perform, and can provide a complete identification in 24 h from the time a blood culture showed growth. Am J Clin Pathol, 1982 Oct, 78(4), 457 - 61 Adaptation of an automated microbiology system for the growth of anaerobes and performance of antimicrobial susceptibility tests; Murray PR et al.; The authors examined the feasibility of growing anaerobes in an automated microbiology system (MS-2) and using the system for antimicrobial susceptibility testing . A total of 78 of 100 clinical anaerobic isolates grew in the MS-2 if 100 microL of an undiluted overnight suspension of organisms was inoculated into at least 2.5 mL of freshly prepared Wilkins-Chalgren broth supplemented with 0.07% agar . Susceptibility test results were determined with 50 anaerobes tested against seven antibiotics in the MS-2 system and were compared with results determined with a qualitative reference susceptibility test method . of the 350 tests, 88% of the MS-2 results agreed with the qualitative reference results . False-susceptible and false-resistant results were reported for 8.6 and 3.4%, respectively, of the MS-2 results. J Bacteriol, 1982 Oct, 152(1), 527 - 9 Cytochrome c3 from the sulfate-reducing anaerobe Desulfovibrio africanus Benghazi: antigenic properties; Singleton R Jr et al.; Antisera were prepared against cytochromes c3 from Desulfovibrio africanus, D . vulgaris, and D . salexigens . Cross-reactions were observed between antisera to D . vulgaris and D . africanus cytochromes and heterologous cytochromes c3 . A weak cross-reaction with antisera against both D . vulgaris and D . africanus cytochromes and the acid form of the D . salexigens cytochrome was seen; the basic form did not react. Br J Obstet Gynaecol, 1982 Sep, 89(Suppl 4), 32 - 40 Studies on uterine tract infections and the IUCD with special reference to actinomycetes; Duguid HL et al.; Since the advent of the plastic IUCD, an increasing number of patients with clinical pelvic actinomycosis have been reported in the literature and in a very much larger number of women, actinomycetes have been identified in cervical smears, either by Papanicolaou stain or specific immunofluorescence . After a 3-year study, we have concluded that actinomycetes can readily be cultured when the growth of more rapidly growing anaerobes is inhibited by metronidazole and anaerobic culture is continued for up to 14 days . We consider that actinomycetes form part of a polymicrobial anaerobic infestation developing in the presence of a foreign body . The organisms are found almost exclusively in women who have used all-plastic IUCDs for a long term and, from a continuing study, it is apparent that most disappear rapidly when the plastic device is removed or replaced by a copper device . Significant symptomatic evidence of infection is found in a small proportion of patients who are actinomycete-positive. Appl Environ Microbiol, 1982 Sep, 44(3), 761 - 4 Aerobic and anaerobic microorganisms in tubercles of the Columbus, Ohio, water distribution system; Tuovinen OH et al.; Aerobic and anaerobic microorganisms were enumerated in tubercles collected from sections of the water distribution pipeline in the Columbus, Ohio, metropolitan area . Coliform bacteria were not detected in the tubercles examined . Sulfate-reducing bacteria were detected in 80% of the samples . Nitrate-reducing heterotrophs were present in all samples . The results, including plate counts of aerobic heterotrophs, indicated variation in bacterial densities depending on the tubercle sample and fraction examined . The associations among the viable counts obtained by the different culture methods were analyzed statistically, using three methods (Pearson, Spearman, and Kendall). Antimicrob Agents Chemother, 1982 Sep, 22(3), 426 - 30 Activity of metronidazole and its hydroxy and acid metabolites against clinical isolates of anaerobic bacteria; O'Keefe JP et al.; Susceptibility of clinical isolates of anaerobic bacteria to metronidazole and its two oxidation products, 1-(2-hydroxyethyl)-2-hydroxymethyl-5-nitroimidazole (the "alcohol" metabolite) and 2-methyl-5-nitroimidazole-1-acetic acid (the "acid" metabolite), were determined by the agar dilution technique . Results disclosed that the alcohol metabolite, although less active than metronidazole, inhibited the organisms tested at levels considered susceptible for metronidazole . The acid metabolite was less active, not inhibiting the organisms at levels within the susceptible range . In other studies, mixtures of known concentrations of metronidazole and the metabolites were assayed in a bioassay system used to measure metronidazole levels . These studies showed that the bioassay will measure metronidazole or the alcohol metabolite; the acid metabolite is not measured at levels achieved in clinical specimens . Since the activity of the alcohol metabolite is comparable to that of metronidazole, we feel that microbiological assays can be used for therapeutic monitoring of metronidazole levels in clinical situations. J Clin Microbiol, 1982 Sep, 16(3), 570 - 2 Evaluation of a prereduced anaerobically sterilized medium (PRAS II) system for identification anaerobic microorganisms; Beaucage CM et al.; A prereduced, anaerobically sterilized system of tubed media (PRAS II; Scott Laboratories, Fiskeville, R.I.) was evaluated for accuracy in the identification of anerobic microorganisms . PRAS II was found to be a rapid and accurate identification system for obligate anaerobes which does not require the use of gas cannula inoculation or incubation in a special anaerobic environment. Scand J Gastroenterol, 1982 Sep, 17(6), 785 - 90 Gallbladder and duodenal bacterial flora after papillotomy in rabbits; Rosseland AR et al.; Gallbladder and duodenal bacteria were studied in New Zealand white rabbits 1 and 4 weeks after papillotomy . The gallbladder bile was sterile in all animals before papillotomy . One and 4 weeks after papillotomy growth of both aerobic and anaerobic bacteria was found in the gallbladder bile in five of eight test animals and in none of the control rabbits . The number of bacteria in the duodenum increased in rabbits that developed growth of bacteria in the gallbladder bile after papillotomy . In the test rabbits that did not develop bacteria in the gallbladder bile and in the control group no changes in duodenal bacteria were observed. Jpn J Antibiot, 1982 Sep, 35(9), 2180 - 8 {Evaluation of the clinical effect and tissue distribution of piperacillin in the field of obstetrics and gynecology}; Chimura T et al.; Piperacillin (PIPC) was administered to patients with obstetrical and gynecological infectious diseases and we studied its clinical effect and tissue distribution . 1 . Clinical results . PIPC was administered to 26 patients at a dose of 2--4 g per day (twice a day) by dripping infusion over a period of 3--10 days (total 8--30 g) . These included 16 cases with intrauterine infection, 1 with adnexitis, 4 with pelvic inflammatory disease and 5 with infections of the external genitalia . The clinical results were excellent in 11 cases, good in 13 cases and poor in 2 cases so that the overall efficacy rate was 92.3% . For bacteriological study 33 strains were isolated from 20 patients . These included Gram positive bacteria (6 strains), Gram negative bacteria (23 strains) and anaerobes (4 strains) . After PIPC treatment 32 strains (including S . epidermidis 4 strains, E . coli 12 strains, K . pneumoniae 3 strains, E . aerogenes 2 strains, P . aeruginosa 2 strains and anaerobes 4 strains, etc.) disappeared except for 1 strain of K . pneumoniae which persisted . The disappearance rate was 97.0% . The only side effect observed was a slight case of malaise during the first administration day, however the relationship between the appearance of this symptom and the drug was unclear . No adverse reaction in laboratory findings was observed . 2 . Tissue distribution . We determined the tissue concentration from 90 to 240 minutes after dripping infusion for 1 hour at a dose of 2 g . PIPC concentrations in these tissues including the endometrium, myometrium, cervix uteri, portio vaginalis, oviduct and ovary showed the highest level (18.0--11.7 micrograms/g) at 90 minutes after the beginning of administration . These values were 48.6--31.6% in respect to the uterine arterial blood level (37 micrograms/ml at 90 minutes after infusion). J Pharm Sci, 1982 Aug, 71(8), 901 - 4 Study of the metabolic conversion of imipramine and desipramine to N-nitrosodesipramine by bacteria using a nitrogen-selective GC analysis; Baker JK et al.; A GC method using dual nitrogen selective and flame ionization detectors was developed for the determination of N-nitrosodesipramine using N-butyryldesipramine as the internal standard . The precision of the method was found to be +/- 5.0% and the accuracy was +/- 4.9% . The method could be used to detect 10 ng/ml of N-nitrosodesipramine in bacterial cultures . When desipramine and sodium nitrite were incubated with aerobic or anaerobic bacteria, the nitrosamine level was found to be 10-300 times higher than the controls . When imipramine and potassium nitrate were incubated with a mixed anaerobic culture, the level of N-nitrosodesipramine was found to be 4.5 times higher than the control. J Clin Microbiol, 1982 Aug, 16(2), 355 - 60 Analysis of short-chain acids from anaerobic bacteria by high-performance liquid chromatography; Guerrant GO et al.; A standard mixture of 25 short-chain fatty acids was resolved by high-performance liquid chromatography, using an Aminex HPX-87 column . The acids produced in culture media by anaerobic bacteria were analyzed by high-performance liquid chromatography after extraction with ether and reextraction into a small volume of 0.1 N NaOH . The presence of fumaric acid in culture extracts of Peptostreptococcus anaerobius was confirmed by gas chromatography-mass spectrometry analysis of the trapped eluent fractions from the high-performance liquid chromatography column. J Clin Microbiol, 1982 Aug, 16(2), 245 - 9 Collaborative evaluation of the micro-media systems anaerobe susceptibility panel: comparisons with reference methods and test reproducibility; Jones RN et al.; The Micro-Media Systems (MMS) anaerobe susceptibility testing panel results from four laboratories were compared for interlaboratory and intralaboratory variations and for the results with the reference agar dilution and a broth microdilution method . The interlaboratory agreement was 98.0% and intralaboratory agreement was 97.3% (+/- 1 log2 dilution) . When interpretive criteria for each antimicrobial agent (susceptible, intermediate, and resistant) were assigned, the MMS anaerobic minimum inhibitory concentration data showed an interpretive accuracy of 91.0 and 95.5% for comparisons to the reference agar dilution and the broth methods, respectively . Most significant interpretive errors were considered minor, and nearly half of all errors involved tetracycline, a drug rarely used for serious anaerobic infections . The MMS anaerobe panels appear to be acceptable for selected use in clinical microbiology laboratories. Acta Pharmacol Toxicol (Copenh), 1982 Aug, 51(2), 165 - 72 Interaction between diphenolic laxatives and intestinal bacteria in vitro; Bergan T et al.; The ability of the laxative diphenols desacetylbisacodyl, oxyphenisatin, and phenolphthalein to inhibit growth and cause leakage of potassium ion from microbial cells in vitro was studied with 25 aerobic and 25 anaerobic bacterial strains . None of the aerobes, but some of the anaerobes showed growth inhibition . Potassium release assayed by flame photometry was observed in strains which showed growth inhibition, but also in other strains including anaerobes and aerobes . The highest antibacterial activity among the diphenols was observed with phenolphthalein and the least with desacetylbisacodyl; this relationship as noted for both growth inhibition and potassium release . Enzymatic hydrolysis of picosulphate to the free diphenol desacetylbisacodyl carried out by three strains of anaerobic bacteria was indicated by high pressure liquid chromatography. Obstet Gynecol, 1982 Aug, 60(2), 232 - 6 Use of single-agent antimicrobial therapy in the treatment of polymicrobial female pelvic infections; Faro S et al.; One hundred twenty patients with either postpartum endomyometritis or postgynecologic surgical infections were treated either with ticarcillin, clindamycin, or chloramphenicol . One hundred nine (91%) responded successfully to single-agent antimicrobial therapy . Most of the infections were polymicrobial, involving both aerobic and anaerobic bacteria . Forty patients were treated with ticarcillin, with 90% responding successfully; 48 were treated with chloramphenicol, with 94% responding successfully; and 32 were treated with clindamycin, with 88% responding successfully . Single-agent antimicrobial therapy appears to be appropriate for treating polymicrobial obstetric and gynecologic soft tissue infections. Drugs, 1982 Aug, 24(2), 85 - 117 Tinidazole in anaerobic infections: a review of its antibacterial activity, pharmacological properties and therapeutic efficacy; Carmine AA et al.; Tinidazole, like the structurally-related drug metronidazole, was initially introduced for treating protozoal infections . However, both these nitroimidazole compounds are also active in vitro against most clinically important obligate anaerobes . Most of the clinical experience with tinidazole to date has involved prophylactic use to prevent postoperative anaerobic infection . Prospective placebo-controlled studies demonstrated that a single dose of tinidazole administered orally prior to elective colorectal surgery significantly reduced postoperative infection . Similarly, when given intravenously prior to appendectomy, tinidazole reduced the incidence of postoperative infection in some subgroups of patients . Although results of non-blinded studies with prophylactic tinidazole were encouraging when used in women undergoing gynaecological surgery (mainly hysterectomy), results from double-blind placebo-controlled studies in this situation have been somewhat equivocal . Thus, although the overall weight of evidence suggests that the drug is effective in this area of use, further study is needed to clarify its role in preventing anaerobic infection following gynaecological surgery compared with other antibiotics which can also be used for this purpose . Relatively few studies have been conducted with tinidazole in the treatment of established anaerobic infections, and this is an area needing further investigation . The drug is well tolerated when administered orally or intravenously. Antibiotiki, 1982 Aug, 27(8), 592 - 5 {Method of determining the antibiotic sensitivity of anaerobic microorganisms using standard disks}; Baltrashevich AK et al.; Three variants of the procedure for determination of antibiotic sensitivity in anaerobic microorganisms with the use of standard paper discs were developed . According to the first variant the solid nutrient medium is melted at 46 degrees C and mixed with the culture of the microbe being tested . The mixture is added to the cover of a Petri dish . When the medium becomes solid, antibiotic sensitivity discs are placed onto the agar surface . After that one more layer of the medium is added . The medium is allowed to solidify and some more medium is poured near the cover edge . Immediately after that the Petri dish is placed with its flat surface onto the agar layer in its cover . According to the first and second variants the mixture of the medium and culture is added to a Petri dish and immediately a transparent gas-proof polymer film of the dish size is placed onto the agar surface . Previously antibiotic paper discs or solutions are fixed on the films . THe incubation temperature for all three variants is 37 degrees C . The procedure allows one to observe the culture growth and to obtain the results earlier than in case the culture is incubated in an aerostate . The procedure is simple and saves labor and time. J Clin Microbiol, 1982 Aug, 16(2), 224 - 9 Gelatin agar medium for detecting gelatinase production by anaerobic bacteria; Whaley DN et al.; A new medium, Lombard-Dowell gelatin agar, was developed for detecting gelatinase activity by anaerobic bacteria . The medium contained: Trypticase (BBL Microbiology Systems), 5.0 g; yeast extract (Difco Laboratories), 5 g; sodium chloride, 2.5 g; sodium sulfite, 0.1 g; L-tryptophan, 0.2 g; L-cystine, 0.4 g; hemin, 10.0 mg; vitamin K1, 10.0 mg; agar, 20.0 g; D-glucose, 1.0 g; gelatin, 4.0 g; and distilled water to 1 liter . The pH was adjusted to 7.5 . The medium was dispensed in 100- by 15-mm quadrant plastic dishes (5 ml per quadrant) . To test for gelatinase activity, we inoculated the medium with a young enriched thioglycolate or chopped meat glucose broth culture or a turbid cell suspension in Lombard-Dowell broth, using a sterile cotton swab, and incubated it under anaerobic conditions for 48 h at 35 degrees C . The quadrants were then flooded with Frazier solution, and clear zones around the bacterial growth were recorded as positive for gelatinase activity . The new medium was tested with a variety of anaerobic bacteria, and the results were compared with data obtained with the conventional technique for detecting gelatinase activity . Overall, there was satisfactory agreement between the two tests in the detection of gelatinase activity, but the Lombard-Dowell gelatin agar tests was more rapid and somewhat more sensitive than the conventional test. Antimicrob Agents Chemother, 1982 Aug, 22(2), 338 - 41 Comparative in vitro activity of ceftriaxone against anaerobic bacteria; Rolfe RD et al.; The in vitro activity of ceftriaxone was compared with those of other recently introduced beta-lactam antimicrobial agents (cefoperazone, cefotaxime, and moxalactam) and with those of cefoxitin, clindamycin, and metronidazole against 227 strains of anaerobic bacteria . The data obtained in this investigation suggest that ceftriaxone, like a majority of the new beta-lactam antimicrobial agents, may be of limited value in the treatment of serious infections involving anaerobic bacteria. J Clin Microbiol, 1982 Jul, 16(1), 99 - 102 Rapid detection of simulated bacteremia by centrifugation and filtration; Herlich MB et al.; A centrifugation-filtration procedure was developed to expedite the recovery of microorganisms from blood . Fresh whole human blood was inoculated with various aerobic and facultatively anaerobic microorganisms (3 to 18 per ml) . The seeded blood was carefully overlaid on a Ficoll-Hypaque gradient (density, 1.114 g/ml) and centrifuged (400 x g) for 45 min at ambient temperature . The entire gradient (plasma, leukocytes, and Ficoll-Hypaque) was removed and filtered through a 0.22-micrometer membrane filter . The filters were then placed on chocolate agar and incubated at 35 degrees C in humidified air containing 5% CO2 . No statistically significant differences were detected between the numbers of microorganisms recovered by filtration and by direct culture of the original inoculum . Most microorganisms were detected within 18 h after filtration . This system has excellent sensitivity and negligible toxicity. J Clin Pathol, 1982 Jul, 35(7), 709 - 14 Gas-liquid chromatography in the diagnosis of anaerobic infections: a three year experience; Watt B et al.; Nearly two thousand clinical samples were examined by direct gas-liquid chromatography over a three year period . Absence of volatile fatty acids (VFAs) in the samples correlated well with negative culture results for anaerobic bacteria . In general the presence of acetic acid alone correlated well with the presence of aerobic organisms, whereas the presence of a mixture of VFAs correlated well with the presence of anaerobic organisms, either alone or in combination with aerobes . However a proportion of such VFA-positive samples gave no growth on culture . Swabs gave comparable results to samples of pus or exudates except that a higher proportion of the former were VFA-negative but culture positive. J Clin Pathol, 1982 Jul, 35(7), 706 - 8 Can direct gas-liquid chromatography of clinical samples detect specific organisms? Watt B, Geddes PA, Greenan OA, Napier SK, Mitchell A. A total of 1929 samples was analyzed by direct gas-liquid chromatography and the volatile fatty acid (VFA) patterns of the positive samples were compared with the results of culture . There was no correlation between any bacterial genus or species and the detailed VFA patterns although the presence of butyric or valeric acids, or both, was generally associated with the presence of anaerobes and that of acetic acid was generally associated with aerobic bacteria; however, the technique could not predict the nature of the subsequent bacterial isolate . There was also poor correlation between the VFA pattern in a given sample and the VFA pattern(s) of anaerobic bacteria subsequently isolated from that sample. Postgrad Med, 1982 Jul, 72(1), 253 - 6, 261-2 Spontaneous bacterial peritonitis in alcoholic cirrhosis with ascites; Rajan RK; Aerobic enteric organisms, especially Escherichia coli, are the most common cause of spontaneous bacterial peritonitis in alcoholic cirrhosis with ascites, despite the preponderance of anaerobic bacteria in the bowel flora . The major routes of infection are transmural migration of gastrointestinal flora, lymphatic spread, and hematogenous seeding . Most patients present with fever and chills, abdominal pain, leukocytosis, and hypotension, although some may be asymptomatic . Differentiation from secondary peritonitis, which is essential in determining appropriate therapy, is difficult . Microbiologic studies of the ascitic fluid can provide valuable clues in this regard . Although most patients respond favorably to antibiotic therapy, mortality is high because of complications of the underlying disorder. Nouv Presse Med, 1982 Jun 5, 11(26), 1991 - 3 {Acute primary infection due to slow-growing anaerobes after total hip arthroplasty (author's transl)}; Furno P et al.; Most early post-operative infections in total hip arthroplasty are due to aerobic bacteria . Anaerobes infections are less common and less easy to diagnose since the organisms are growing slowly . In the three patients reported the responsible organisms were detected by a strict bacteriological technique including cultures lasting more than 48 hours . Treatment consisted of re-operation and appropriate antibiotic therapy . The slow development of anaerobic bacteria makes antibiotic sensitivity tests particularly difficult to read . The need for cultures prolonged beyond 48 hours partly explains the frequency of overt suppuration in cases where standard bacteriological methods had given negative results. Ophthalmology, 1982 Jun, 89(6), 636 - 42 Anaerobic corneal ulcers; Perry LD et al.; In a series of 162 bacterial corneal ulcers, 27 were culture positive for anaerobic organisms . Applying strict microbiologic criteria, 11 ulcers were determined to be due to anaerobic infection . No morphologic characteristic was identified to distinguish anaerobic from other types of corneal ulcers . All of the anaerobic ulcer patients manifested one or more predisposing factors . A total of 13 anaerobes were cultured from the 11 confirmed anaerobic ulcers . Five previously unreported anaerobic strains were identified as causes of bacterial keratitis . Over one third of the anaerobic organisms occurred in mixed cultures with other organisms . Most of the anaerobic isolates were susceptible to all antibiotics routinely used for their treatment . The use of topical chloramphenicol is recommended for treatment of confirmed anaerobic ulcers, and topical cefazolin or one of the other cephalosporins effective against anaerobes is suggested to be included in the treatment of all ulcers requiring broad spectrum antibiotic coverage. J Bacteriol, 1982 Jun, 150(3), 1252 - 8 Properties of oxaloacetate decarboxylase from Veillonella parvula; Ng SK et al.; Oxaloacetate decarboxylase was purified to 136-fold from the oral anaerobe Veillonella parvula . The purified enzyme was substantially free of contaminating enzymes or proteins . Maximum activity of the enzyme was exhibited at pH 7.0 for both carboxylation and decarboxylation . At this pH, the Km values for oxaloacetate and Mg2+ were at 0.06 and 0.17 mM, respectively, whereas the Km values for pyruvate, CO2, and Mg2+ were 3.3, 1.74, and 1.85 mM, respectively . Hyperbolic kinetics were observed with all of the aforementioned compounds . The Keq' was 2.13 X 10(-3) mM-1 favoring the decarboxylation of oxaloacetate . In the carboxylation step, avidin, acetyl coenzyme A, biotin, and coenzyme A were not required . ADP and NADH had no effect on either the carboxylation or decarboxylation step, but ATP inhibited the carboxylation step competitively and the decarboxylation step noncompetitively . These types of inhibition fitted well with the overall lactate metabolism of the non-carbohydrate-fermenting anaerobe. Jpn J Antibiot, 1982 Jun, 35(6), 1462 - 74 Bacteriological evaluation of midecamycin acetate and its metabolites; Yoshida T et al.; In vitro midecamycin acetate was shown to have broad spectrum of antibacterial activities similar to those of other macrolides (midecamycin, josamycin, 9-propionyl josamycin and 2'-ethylsuccinyl erythromycin), which include Gram-positive organisms, a part of Gram-negative organisms and anaerobes . Metabolites of midecamycin acetate also showed certain degree of antibacterial activities although they gave higher MIC values than midecamycin acetate . The antibacterial activities of midecamycin acetate were potentiated in the medium with pH 7 or pH 8 and little affected by inoculum size or addition of human serum into the medium . Both midecamycin acetate and its metabolites were found to have relatively high protein binding rates . In vivo therapeutic experiments in experimental infections in mice, midecamycin acetate was shown to be much superior to other drugs tested in the therapeutic efficacy against intraperitoneal infections caused by Staph . aureus, Strept . pyogenes, Strept . pneumoniae and Cl . perfringens . In infections transnasally induced by Strept . pneumoniae, midecamycin acetate showed therapeutic efficacy 2 or 5 times greater than that of josamycin or midecamycin, despite that MICs of midecamycin acetate were equal to josamycin or midecamycin . Moreover, midecamycin acetate showed high therapeutic efficacy for subcutaneous infections due to Staph . aureus, suggesting that it exerts pronounced antibacterial activities against not only systemic infections but also local infections. Appl Environ Microbiol, 1982 Jun, 43(6), 1419 - 24 Effects of kepone on growth and respiration of several estuarine bacteria; Mahaffey WR et al.; The toxicity of Kepone to mixed populations of estuarine microorganisms was determined by standard plate assays on Zobell marine medium containing 0.02, 0.20, and 2.0 mg of Kepone per liter . Under aerobic conditions, Kepone reduced the number of colony-forming units at all concentrations tested, but had no effect on the number of anaerobic microorganisms . Gram-positive organisms were more sensitive to Kepone than were gram-negative organisms . Growth of gram-negative isolates was not inhibited in nutrient broth, but was significantly inhibited in a minimal salts broth . Oxygen uptake by most isolates was reduced 25 to 100% by 20 ppm (20 mg/ml) of Kepone . Oxygen evolution was observed when several gram-positive isolates were exposed to Kepone concentrations of 20 ppm . Pentachlorophenol at concentrations above 28 ppm produced effects similar to those produced by Kepone . Inhibition of electron transport by Kepone was demonstrated by a significant reduction in the specific activities of NADH oxidases and succinooxidase. J Clin Pathol, 1982 May, 35(5), 555 - 60 A transport method for swab specimens submitted for aerobic and anaerobic bacteriology; Alfa M et al.; The need for separate swab transport methods for aerobes and anaerobes may result in inadequate transport of specimens for anaerobic bacteriology . Most microbiology laboratories in Australia rely on Stuart's transport medium to protect anaerobic bacteria . This paper presents a new, simple transport medium (Transport Deep) suitable for sue with aerobes and anaerobes . Comparative evaluations demonstrate that Transport Deep is as good as Stuart's medium for the maintenance of fastidious bacteria and is far superior for the protection of even extremely oxygen-sensitive anaerobes . This medium has been used successfully in a large Sydney hospital for more than a year . It is proposed that Transport Deep be used on a routine basis for all swab specimens. Surg Gynecol Obstet, 1982 May, 154(5), 715 - 20 A prospective randomized controlled trial of cefoxitin versus clindamycin-aminoglycoside in mixed anaerobic-aerobic infections; Drusano GL et al.; Ninety patients infected with presumed penicillin resistant anaerobes were randomized to cefoxitin or clindamycin-aminoglycoside . Cefoxitin was comparable to clindamycin-aminoglycoside in cures of intestinal associated, 16 of 26 versus 11 of 21, and pelvic infections, 20 of 20 versus 22 of 23 . Cefoxitin-resistant facultative-aerobic gram-negative rods were found in 16 of 45 patients with intestine associated infection . Probable antibiotic associated nephrotoxicity was less frequent in the patients in the cefoxitin group, zero of 46 versus seven of 44, p less than 0.05, although a false creatinine elevation was noted more frequent, seven of 46 versus one of 44, p less than 0.05 . Infections causing failure in patients in the cefoxitin group more frequently contained cefoxitin resistant gram-negative rods at the time of failure than did infections causing failure in those in the clindamycin-aminoglycoside group that contained gentamicin-resistant gram-negative rods, eight of eight versus zero of eight, p less than 0.001 . Cefoxitin may be adequate therapy for many patients with mixed anaerobic/aerobic infections; however, the addition of an aminoglycoside may be prudent in those with known, or suspected, cefoxitin resistant gram-negative rods. Zentralbl Bakteriol Mikrobiol Hyg {A}, 1982 May, 252(1), 116 - 28 {Comparative study with 2 new and 8 known nutrient media for cultivation of fastidious and nonfastidious microbial agents from cerebrospinal fluid and other body fluids}; Abdou MA et al.; Rapid physical, biochemical and immunological methods may be useful in the detection of microbial agents in cerebrospinal fluid and in other body fluids . However, these methods are no substitution for the cultivation of the microbial agents . Microorganisms which are most frequently responsible for meningitis are fastidious in their growth requirements . Their detection with the help of conventional blood culture media which are not supplemented with blood or its components, leads to a high quota of false-negative results . Taking this problem into consideration, the authors developed the following two new media: "MOPS Electrolyte Broth A" for culturing obligate aerobic and facultative anerobic microorganisms, and "MOPS Electrolyte Broth AN" for culturing facultative anaerobic and obligate anaerobic bacteria . Performance tests have been carried out with the two above mentioned media and eight commercially manufactured blood culture media in original bottles . Twenty representative test strains including the most important and fastidious microbial agents of meningitis have been considered in this study . The inoculum size was about 10(2) CFU per culture bottle . The two new media, which were not supplemented with blood or body fluids, proved to be more effective than the conventional blood culture media supplemented with 10% fresh human blood for culturing the considered spectrum of microorganisms. J Periodontol, 1982 May, 53(5), 319 - 24 Value of antibiotic prophylaxis in periodontal surgery; Appleman MD et al.; THE MORBIDITY and incidence of bacteremia in periodontal surgery with or without cephalexin prophylaxis were assessed in adults on the basis of clinical evaluations and blood cultures . Cephalexin reduced the incidence of polymicrobic bacteremias . There was no correlation between objective signs of tissue healing and antibiotic coverage in treated or nontreated patients . In vitro antibiotic susceptibility data showed that cephalexin was active against the aerobic and anaerobic bacteria isolated from blood specimens taken during surgery. Obstet Gynecol, 1982 May, 59(5), 550 - 5 Pelvic inflammatory disease: etiologic studies with emphasis on chlamydial infection; Gjonnaess H et al.; Chlamydia trachomatis is one of the main etiologic agents in pelvic inflammatory disease (PID) in Oslo . Up to two thirds of the 65 PID cases studied were associated with a chlamydial infection . The incidence of cervical gonorrhea was low (7.7%) . Anaerobic bacteria were not isolated from the fallopian tubes or peritoneal fluid of any of the patients . Chlamydia-associated PID is characterized by a protracted course and vague symptoms . The laparoscopic findings indicate more severe inflammatory changes of the tubes than in patients in whom these agents were not found . The highest incidence of chlamydia-associated PID occurred in younger subjects, among whom the intrauterine contraceptive device was more frequently used . Perihepatitis was diagnosed in PID patients with and without chlamydial infection of the genital tract. Mol Cell Biol, 1982 Apr, 2(4), 369 - 77 Attachment of the flagellate Giardia lamblia: role of reducing agents, serum, temperature, and ionic composition; Gillin FD et al.; The flagellated protozoan Giardia lamblia has been grown only in highly complex media under reduced oxygen tension . Therefore, the organic and physiological requirements for in vitro attachment and short-term (12-h) survival of this organism were determined . In defined maintenance media, a thiol reducing agent (e.g., cysteine) was absolutely required for attachment and survival of this aerotolerant anaerobe . The crude bovine serum Cohn III fraction greatly stimulated attachment and survival . Attachment was decreased at a reduced temperature (24 degrees C as compared with 35.5 degrees C) and absent at 12 degrees C or below . Attachment and survival were strongly dependent upon pH and ionic strength, with optima at pH 6.85 to 7.0 and 200 to 300 mosmol/kg . Sodium chloride was better tolerated than KC1 . Reduction of Ca2+ and Mg2+ to below 10(-8) M did not significantly affect attachment. Clin Orthop, 1982 Apr, (164), 136 - 40 Chronic sclerosing osteomyelitis (Garré); Collert S et al.; Eight patients with chronic sclerosing osteomyelitis (Garre) were investigated for an average follow-up of 13 years . The disease is a well definable clinical entity affecting children and young adults . Secondary lesions occurred in four cases after an average of 5.5 years . Five patients with a history of an average of eight years duration were free of symptoms . whereas the remaining three patients with a history of six, 13, and 15 years, respectively, had intermittent recurrences . The roentgenologic findings showed pronounced sclerosis interspersed with cystic areas . In all cases except one the sclerosis remained unchanged or progressed, even when the patient was free of symptoms . There are indications that the condition may have its origin in an infection caused by low-virulent, anaerobic bacteria . Present methods of treatment appeared to have little, if any effect, on the progress of the disease. Arch Surg, 1982 Apr, 117(4), 445 - 9 Biliary bacteria: significance and alterations after antibiotic therapy; Pitt HA et al.; Patients undergoing urgent and complex biliary operations were studied to determine (1) whether bactibilia is associated with postoperative complications amd (2) whether antibiotic therapy influences biliary bacteriology . Aerobic and anaerobic cultures were performed on hepatic bile obtained at surgery in 134 patients . Cultures were repeated four to seven days postoperatively in 111 patients who had indwelling biliary tubes . Positive operative bile cultures were associated with an increased incidence of wound infection and postoperative renal dysfunction . Postoperative bile cultures showed a significant increase in the number of patients having bactibilia, and a significant alteration in the types of organisms isolated . Anaerobes were cultured from 15% of operative and 23% of postoperative cultures . Antibiotic therapy did not sterilize bile, but merely altered biliary bacteriology . Furthermore, prolonged aminoglycoside therapy was associated with a high incidence of renal dysfunction, especially in elderly patients. J Clin Pathol, 1982 Apr, 35(4), 458 - 61 Evaluation of Fastidious Anaerobe Broth as a blood culture medium; Ganguli LA et al.; Three commercial blood culture media were compared with a freshly prepared cooked meat medium in tests to stimulate the recovery of small inocula of anaerobic and aerobic bacteria in routine blood cultures . The cooked meat medium gave the most reliable recovery and supported continued viability, whilst Fastidious Anaerobe Broth (LAB M) was a good alternative . Results with Southern Group thioglycollate and Difco Thiol were less satisfactory as delays in recovery and loss of viability occurred on continued incubation with some of the test strains. Am J Obstet Gynecol, 1982 Apr 1, 142(7), 896 - 900 Impact of diverging anaerobic technology on cul-de-sac isolates from patients with endometritis-salpingitis-peritonitis; Monif GR et al.; The probability of obtaining accurate identification of bacteria present in the cul-de-sac in cases of polymicrobial bacterial endometritis-salpingitis-peritonitis (ESP) was analyzed on the basis of a comparison of bacteriologic data derived from the hospital laboratory and those engendered by a research anaerobic laboratory . Two sets of paired cul-de-sac specimens from 20 cases of ESP were analyzed at two different laboratories whose anaerobic technology differed from that of the reference laboratory . At University Hospital (Jacksonville, Florida), 22 of 36 (61%) aerobic bacterial isolates were correctly identified, in contrast to only eight of 52 (15.4%) anaerobic isolates . The clinical facility of the University of Florida College of Medicine (Gainesville, Florida) identified 28 of 32 (86.5%) aerobic and 16 of 34 (47.9%) anaerobic isolates . The probability of accurately delineating the anaerobic bacteria present in polymicrobial peritonitis which may develop in patients with acute salpingitis was directly related to the degree of sophistication in anaerobiology . Since most institutions cannot provide sophisticated anaerobiology, the authors contend that therapy cannot be contingent upon microbiologic data and that the clinician must rely primarily on clinical and biophysical parameters to monitor the effectiveness of therapy. Br Med J (Clin Res Ed), 1982 Mar 20, 284(6319), 859 - 60 Anaerobic balanoposthitis; Cree GE et al.; To assess the causative role of non-sporing anaerobes in cass of erosive balanoposthitis, anaerobic culture was performed on purulent discharges from 104 patients with penile ulceration, a foul-smelling discharge, and a mixed and motile bacterial flora . Most of 29 culturally confirmed infections were due to mixed anaerobes and eight to single anaerobes . A rapid response to treatment with metronidazole also confirmed the anaerobic cause of the infection . Thus, acute anaerobic balanoposthitis can be readily diagnosed clinically and is easily treated. Antimicrob Agents Chemother, 1982 Mar, 21(3), 441 - 9 Intravenous metronidazole for treatment of infections involving anaerobic bacteria; George WL et al.; Intravenous metronidazole was administered, either by continuous or intermittent infusion, to 20 patients with infections involving anaerobic bacteria; 14 of the 20 patients were changed to oral administration of metronidazole for completion of therapy . Six of eight patients with infections derived from oropharyngeal bacterial flora were cured; the addition of ampicillin was required in one patient, however, because of an incomplete response to metronidazole . Eight of eleven evaluable patients with infections derived from bowel flora were also cured by metronidazole or metronidazole plus an aminoglycoside . Of 93 anaerobic bacteria isolated before therapy, 89 were susceptible to 16 micrograms or less of metronidazole per ml . Mean plasma levels of metronidazole were 27.6 +/- 11.4 micrograms/ml in patients receiving continuous infusions of drug and 19.9 +/- 10.7 micrograms/ml (trough) in patients receiving intermittent infusions . Two patients developed peripheral neuropathy during therapy . Metronidazole is an effective agent for the treatment of anaerobic infections . Because metronidazole is not active against facultative and aerobic bacteria, the addition of a second antimicrobial agent may be required for the treatment of mixed anaerobic-aerobic infections. Br J Surg . 1982 Mar;69(3):156. Ureteric obstruction due to pelvic actinomycosis; Brown R et al.; PIP: Since 1973 several reports of pelvic actinomycosis arising in association with modern types of IUDs have appeared . Various presentations occur such as vaginal discharge, tubo-ovarian abscess, or "frozen pelvis." Ureteric obstruction is uncommon and its management unclear . A case is presented of ureteric obstruction due to pelvic actinomycosis associated with an IUD . A 34 year old woman presented with a 6 month history of alternating constipation and diarrhea, weight loss, amenorrhea, and laterally, a vaginal discharge . A Lippes loop had been inserted 2 years earlier . On examination, she was anemic, cachectic, pyrexial and had a frozen pelvis . There was a stricture of the midrectum but the mucosa was intact . The strings of the IUD could be felt and the cervix appeared normal . There was skin redness and induration over the right ischiorectal fossa . Intravenous urogram showed bilateral hydronephrosis with hydroureter . Examination under anesthesia confirmed the midrectal stricture . Biopsies showed mild inflammatory changes only . The IUD was removed and curettings revealed an acute endometritis . At laparotomy, apparently normal small bowel loops were adherent to a friable mass in the pelvis, which displaced the bladder forwards . The colon and uterus appeared normal but bilateral pyosalpinges were present and were resected . Neither ovary could be identified . Despite the tubal infection, pelvic malignancy was suspected and a sigmoid colostomy fashioned in view of impending rectal obstruction . Histology of the mass showed a large amount of fibrous tissue infiltrated by acute and chronic inflammatory cells and containing micro-abscesses . In 2 places only, colonies of actinomycetes surrounded by polymorphs were observed . No sulphur granules were identified . No growth was obtained on aerobic and anaerobic culture of the tissue and the pyosalpinges . Treatment with penicillin V 500 mg q.d.s . produced an allergic reaction and was changed to tetracycline 250 mg q.d.s . which was continued for 2 months at home . 4 months later, the rectal stricture had resolved and the colostomy was closed . 9 months after the initial presentation a urogram showed complete resolution of the left hydronephrosis . There was slight residual right hydronephrosis but no evidence of ureteric obstruction . Urology, 1982 Mar, 19(3), 256 - 8 Use of oral metronidazole HCl (Flagyl) for posturethritis syndrome; Toth A; Six men with nongonococcal urethritis (NGU) who remained symptomatic after specific therapy with different antibiotic regimens were empirically treated with either of two regimens of oral metronidazole: 500 mg., three times a day for ten days, or 2.5 Gm . (10 x 250 mg.) orally in one dose . All patients had pretreatment seminal fluid cultures . No significant pathogen could be isolated . Side effects included generalized weakness, gastrointestinal symptoms, and a characteristic metallic taste . All patients became asymptomatic after therapy . The single-dose therapy seemed to be more effective in persistent cases . Since metronidazole is active only against anaerobic bacteria, it is postulated that currently unidentified anaerobic bacteria may play a role in at least some cases of posturethritis syndrome. Proc Natl Acad Sci U S A, 1982 Mar, 79(5), 1578 - 82 Properties of a Saccharomyces cerevisiae mtDNA segment conferring high-frequency yeast transformation; Hyman BC et al.; The bakers' yeast Saccharomyces cerevisiae is a facultative anaerobe, tolerant to mutations in its mitochondrial genome . Individual cytoplasmic petite mutants retain genetic information derived from any portion of the parenteral mtDNA, prompting questions concerning distribution of the DNA replication origin(s) on the yeast mitochondrial genome . The experiments described in this paper were designated to test the possibility of using high-frequency yeast transformation as a selection for yeast mtDNA sequences conferring autonomously replicating function . A complete petite mitochondrial genome was inserted into the yeast vector YIp5, and the hybrid plasmid (YRMp1) was used to transform yeast . YRMp1 promoted high-frequency transformation of both wild-type yeast cells and petite mutant hosts lacking mtDNA and was maintained in each of these strains as a high-copy-number extrachromosomal element . The stability and copy-number properties of YRMp1 are similar to those of YRp12, a recombinant plasmid containing a yeast chromosomal autonomously replicating sequence. Antimicrob Agents Chemother, 1982 Mar, 21(3), 367 - 72 Effect of systemic antimicrobial prophylaxis on microbial flora; Bodey GP et al.; Fifteen patients undergoing intensive chemotherapy for oat cell carcinoma of the lung in a protected environmental unit received antimicrobial prophylaxis with oral trimethoprim-sulfamethoxazole and short courses of parenteral ticarcillin, tobramycin, and miconazole . Altogether, 58 (65%) of 89 strains of aerobic bacteria and 28 (60%) of 47 strains of anaerobic bacteria present before prophylaxis were no longer cultured from stool specimens during prophylaxis . Ten strains of bacteria and four fungi were acquired in the stools during prophylaxis . Most fungi persisted in the throat and stools during prophylaxis . Bacterial infections occurred infrequently, but three patients developed Candida esophagitis . The regimen was well tolerated with minimal side effects. JAMA, 1982 Feb 26, 247(8), 1149 - 52 Detection and prevalence of IUD-associated Actinomyces colonization and related morbidity . A prospective study of 69,925 cervical smears; Valicenti JF Jr et al.; PIP: Cervical Papanicolaou smears from a population of 69,700 women including 6450 IUD users were prospectively analyzed for the presence of Actinomyces israelii during a 20-month period . No clinical evidence of actinomycete-like organisms was found in any non-IUD wearers . In IUD users, 212 Papanicolaou stained smears or 1.6% were found positive with actinomycetes when examined by light microscopy . The length of time of IUD insertion averaged 6.1 years, with a range from 6 months to 14 years . A 2nd study of 225 family planning clinic patients revealed a 5.3% prevalence of Actinomyces israelii among IUD users . Average length of IUD use was 6.5 years, with a range of 1-14 years . Direct immunofluorescence appeared more accurate for diagnosis than light microscopy or Pap smears . The study suggests that protracted IUD use predisposes to a higher incidence of infection . No specific type of IUD was associated with higher risk . Only 2 patients had clinically significant infection and most were asymptomatic, suggesting that the organism causes a superficial infestation of the endometrium which is shed with the menstrual period . Full diagnostic workup with appropriate therapy is required for the management of clinically proven infection, while asymptomatic women with cytological evidence of Actinomyces may require conservative management, including IUD removal and repeated Pap smears . Biochem Pharmacol, 1982 Feb 1, 31(3), 411 - 4 Comparative misonidazole metabolism in anaerobic bacteria and hypoxic Chinese hamster lung fibroblast (V-79-473) cells; Koch RL et al.; The metabolism of the radiation sensitizer misonidazole was similar in anaerobic cecal contents and hypoxic Chinese hamster lung fibroblasts (V-79-473) . Both systems formed the amino derivative of misonidazole, {1-(2-aminoimidazol-1-yl)-3-methoxypropan-2-ol} (AIM), and urea, as well as a metabolite, (2-hydroxy-3-methoxypropyl)-guanidine (G), which has not been described previously . It appears that the nitro group of misonidazole was reduced to form AIM and that this compound was then hydrolyzed to yield either urea or G, the latter in yields of 25% (tissue culture) to 55% (cecal contents) . When tested with the Ames tester strain, both G and AIM were slightly mutagenic only for strain TA 98 and then only in the presence of the system for microsomal activation. Am Rev Respir Dis, 1982 Feb, 125(2), 251 - 4 Thoracic actinomycosis caused by actinomyces meyeri; Rose HD et al.; Two patients with chest infections caused by Actinomyces meyeri were seen during a 5-yr period . One patient was ill for 2 yr and had chronic infection manifested by bilateral cavitary and fibrotic changes on chest roentgenogram . A . meyeri was isolated from a chest wall lesion, transtracheal aspirate, and lung tissue . The other patient presented with a subcutaneous abscess of the left hip that yielded A . meyeri on culture . A localized lung infection and empyema were found . Both patients had other aerobes or anaerobes recovered from material haboring A . meyeri, a frequent finding in actinomycosis caused by Actinomyces israelii . To our knowledge, thoracic actinomycosis caused by A . meyeri has not been previously described. Oral Surg Oral Med Oral Pathol, 1982 Feb, 53(2), 194 - 7 Humoral antibodies to anaerobic bacteria isolated from patients with pulpal-periapical disease; Keudell K et al.; The purpose of this investigation was to determine if anaerobic bacteria isolated from pulpal-periapical infections elicit a humoral immune response in the host . Results indicated that patients with pulp and periapical disease do not have significantly raised levels of IgG or IgM in their serum and that in the acute sera the precipitin antibody titer to the anaerobic bacteria was significantly higher in the patient group than in the control group . However, there was no significant difference in antibody titer for the convalescent sera in the patient and control groups or the acute and convalescent sera for the patient group. Zentralbl Gynakol, 1982, 104(2), 137 - 41 {Metronidazole for treatment of puerperal mastitis (author's transl)}; Amon K et al.; Pathogenic anaerobic bacteria may be among the causes of puerperal mastitis which, therefore, was treated by the authors with metronidazole (Vagimid) and with antibiotics, such as penicillin, oxacillin, erythromycin, and oxytetracycline . Best results were obtained by administration of metronidazole to patients in early mastitis . The frequency of incisions was reduced . The therapeutic results obtained from the use of metronidazole on patients with advanced mastitis were identical with those obtained from antibiotics.--Metronidazole concentrations were equal in serum and milk . No side effects were observed. Acta Chir Acad Sci Hung, 1982, 23(3), 135 - 43 Metronidazole in the chemoprophylaxis of colon and rectum operations; Szabo LE et al.; In the preparation of colorectal operations, beside the mechanical cleaning of the bowels, orally administered metronidazole, acting on anaerobic bacteria, was found to be highly effective . Compared to the controls, the drug considerably reduced the number and severity of postoperative infections, and, consequently, also the mortality . With metronidazole prophylaxis no wound suppuration indicating anaerobic infection was noted . The combined application of metronidazole with some antibiotic acting on the aerobic bacteria of the intestinal flora resulted in a significant reduction of postoperative infections. Digestion, 1982, 25(3), 186 - 93 Influence of metronidazole on the breath hydrogen response and symptoms in acarbose-induced malabsorption of sucrose; Lembcke B et al.; The influence of metronidazole on the breath hydrogen response and symptoms of sucrose malabsorption was investigated in a double-blind, randomized and controlled study . Carbohydrate malabsorption was induced by the competitive alpha-glucosidase inhibitor, acarbose . Metronidazole reduced flatulence and the breath hydrogen response during sucrose malabsorption without a change in intestinal carbohydrate absorption, as indicated by serum levels of gastric inhibitory polypeptide, serum insulin and blood glucose . The effect of metronidazole suggests that anaerobic bacteria mediate both signs and symptoms of the colonic response to sucrose malabsorption . In contrast to previous reports on lactose malabsorption, it was not possible to quantify sucrose malabsorption by comparing the breath hydrogen response to sucrose malabsorption with the H2 response to a lactulose load. Ann Chir Gynaecol, 1982, 71(6), 317 - 20 Comparison of metronidazole with clindamycin-gentamycin combination in the prevention of infectious complications after elective colonic surgery; Huttunen R et al.; The efficacy of metronidazole, active only against anaerobes, and clindamycin-gentamycin combination, covering both anaerobes and aerobes, in the prevention of infectious complications after elective colonic surgery was compared in a prospective randomized trial over a three-year period . A total of 130 patients were accepted for the trial, 67 receiving metronidazole intrarectally and 63 receiving clindamycin-gentamycin combination . The prophylactic treatment was started on the evening before the operation and continued for 24 hours . One patient out of 67 receiving metronidazole (1.5%) and two patients out of 63 receiving clindamycin-gentamycin (3.2%) developed a wound infection . An intra-abdominal infection occurred in two patients in both groups (3% and 3.2%, respectively) . There was no statistically significant difference in postoperative infections between the groups . The authors conclude that metronidazole is as effective as the clindamycin-gentamycin combination and should be preferred to broad-spectrum antibiotics because of its fewer side effects and lower potential of developing resistant bacterial strains. Carcinogenesis, 1982, 3(11), 1255 - 60 Metabolism of azo dyes derived from benzidine, 3,3'-dimethyl-benzidine and 3,3'-dimethoxybenzidine to potentially carcinogenic aromatic amines by intestinal bacteria; Cerniglia CE et al.; The metabolism of a benzidine-based dye, Direct Black 38, a 3,3'-dimethylbenzidine-based dye, Direct Red 2 and a 3,3'-dimethoxybenzidine-based dye, Direct Blue 15 has been studied both in pure cultures of anaerobic bacteria and in bacterial suspensions derived from the intestinal contents of the rat . All of the pure cultures and the rat intestinal bacteria were able to reduce the azo linkages of Direct Black 38, Direct Red 2 and Direct Blue 15 with the subsequent formation of benzidine, 3,3'-dimethylbenzidine and 3,3'-dimethoxybenzidine, respectively . The metabolites of Direct Black 38, Direct Red 2 and Direct Blue 15 were isolated and identified by gas chromatography/mass spectrometry and had similar chromatographic and mass spectral properties with those of authentic standards . Results from this study indicate that in vitro anaerobic incubations of rat intestinal microorganisms were able to reduce and cleave the azo bonds of dyes derived from benzidine, 3,3'-dimethylbenzidine and 3,3'-dimethoxybenzidine to form potentially carcinogenic aromatic amines. Digestion, 1982, 24(2), 112 - 7 Effect of ethanol on biliary unconjugated bilirubin and its implication in pigment gallstone pathogenesis in humans; Di Padova C et al.; Though some epidemiological investigations support the association between pigment gallstone formation and chronic alcoholism with cirrhosis, little attention has been paid to the influence of alcohol itself on biliary bilirubin secretion, so that the pathogenesis of pigment cholelithiasis in alcoholics is hitherto unknown . On different days we intravenously administered ethanol (0.7 g/kg body weight), diluted with 500 ml of saline, or saline alone to 6 non-obese patients with an indwelling T tube and reestablished enterohepatic bile circulation . At the time of the investigation bile cultures were negative for aerobic and anaerobic bacteria . Ethanol significantly increased biliary unconjugated bilirubin in respect to control values . The phenomenon reached a maximum 2 h after alcohol infusion when the value of unconjugated bilirubin averaged 2.37 +/- 0.30% of total bilirubin in contrast to 0.65 +/- 0.14% in control conditions (p less than 0.01), and subsided 6 h after the end of ethanol infusion . Since increased amounts of biliary unconjugated bilirubin predispose to pigment stone formation, it can be speculated that alcohol contributes to pigment cholelithiasis pathogenesis by enhancing the biliary concentrations of this form of pigment. Postgrad Med J, 1982 Jan, 58(675), 20 - 4 The penetration of metronidazole into synovial fluid; Sattar MA et al.; Six patients with non-infected synovial effusions, associated either with inflammatory or degenerative arthropathy and requiring diagnostic or therapeutic aspiration, were given a short course of 400 mg metronidazole (Flagyl) 8-hourly for 3 doses . Serum and synovial fluid (SF) were sampled frequently during this time, and assayed for metronidazole by a specific high pressure liquid-chromatographic method . It was found that concentrations of metronidazole in SF reached those in serum after a short time-lag, and thereafter approximated to the serum concentration . With this regimen, metronidazole concentrations were readily achieved in synovial fluid, above the minimum inhibitory concentrations for most susceptible anaerobes . These results indicate that the drug freely enters the synovial fluid and suggests that metronidazole would prove effective in the treatment of septic arthritis due to anaerobic bacteria. Gynecol Obstet Invest, 1982, 13(1), 2 - 8 Bacteriologic aspects of pelvic inflammatory disease in gynecologic patients; Creatsas GK et al.; The bacteriology of acute pelvic inflammatory disease (PID) was studied in 65 women . Endometrial, endocervical and vaginal cuff cultures were taken . In some cases blood cultures and cultures from the cul-de-sac or pelvic abscess were also obtained . Mixed organisms (aerobes and anaerobes) were the most common isolates from the endometrial, endocervical or vaginal cuff cultures, present in 40% . Neiseria gonorrhoeae was isolated in 8 (12.30%) endocervical specimens . Anaerobes were the most common bacteria recovered from cul-de-sac aspirates, pelvic abscesses and blood cultures . The combination of gentamicin, penicillin and metronidazole was the most common antibiotic scheme used . However, other antibiotics as cefoxitin and clindamycin were also used according to the sensitivity test . These data support the polymicrobial etiology of the disease and suggest: (1) the high incidence of anaerobic or mixed infections, and (2) the relatively low incidence of gonococcus in the studied cases. Acta Obstet Gynecol Scand, 1982, 61(1), 21 - 4 Infertility and uterine colonization with Ureaplasma urealyticum; Stray-Pedersen B et al.; Samples of cervical mucus and endometrial tissue from 379 women who were infertile for various reasons were examined for the presence of Ureaplasma urealyticum, and the results were compared with those obtained in 40 fertile women . In the cervical samples U . urealyticum was present in about half of the women in both groups, whereas positive cultures from the endometrium were obtained significantly more often among the infertile patients (26%) than among the controls (7.5%) . Between the different infertility subgroups (unaccountable infertility, infertility caused by tubal abnormalities, husband infertility and other known causes) no significant differences were found . The presence of U . urealyticum in the endometrium was asymptomatic and was not related to prior pelvic inflammatory disease . In 14% of the Ureaplasma-positive endometria, aerobic or anaerobic bacteria were demonstrated . A treatment trial was also included in the study, but did not arrive at any definite conclusion as to the specific role of endometrial Ureaplasma colonization in infertility. Appl Environ Microbiol, 1982 Jan, 43(1), 255 - 6 Simple and convenient method for culturing anaerobic bacteria; Behbehani MJ et al.; A simple and convenient method for culturing anaerobic bacteria is described . Cultures can be grown in commercially available flasks normally used for preparation of sterile external solutions . A special disposable rubber flask closure maintains anaerobic conditions in the flask after autoclaving . Growth of a variety of anaerobic oral bacteria was comparable to that obtained after anaerobic incubation of broth cultures in Brewer Anaerobic Jars. J Infect Dis, 1982 Jan, 145(1), 1 - 8 Quantitative bacteriology of amniotic fluid from women with clinical intraamniotic infection at term; Gibbs RS et al.; Amniotic fluid was collected through an intrauterine catheter from 52 women with clinical intraamniotic infection and from 52 uninfected matched control women . The amniotic fluid was cultured quantitatively for anaerobes and aerobes . Patients with intraamniotic infection were matched with the control women on the basis of gestational age, interval from membrane rupture to specimen collection, and interval from membrane rupture to delivery . The patients with intraamniotic infection had a significantly higher mean temperature (38.4 vs . 37.1 C) and a higher mean leukocyte count (15,740 vs . 11,740 cells/mm3) . In 80.6% of specimens from the women with intraamniotic infection and 30.8% of those from the control subjects, greater than or equal to 10(2) colony-forming units (cfu)/ml were isolated from the amniotic fluid (P less than 0.001) . Also, in 69.2% of the former and 7.7% of the latter, there were greater than or equal to 10(2) cfu of isolates considered to be "high-virulence" isolates/ml (P less than 0.001). Scand J Infect Dis Suppl, 1982, 35, 31 - 6 Antibiotic sensitivity testing of anaerobes; Phillips I; Most of the methods devised for testing the antibiotic susceptibility of aerobes have been applied to anaerobes . In addition to the problems intrinsic to these methods, additional difficulties arise from anaerobiosis itself, from variability of carbon dioxide concentrations and pH, from problems in preparation and definition of inoculum, from the rich media required for growth by some fastidious anaerobes, and from the lack of suitable control microorganisms of known sensitivity . Among the procedures described, MIC determination on solid media is suitable for research and for use as a standard, and MIC in liquid media for routine use but disc tests are of limited usefulness . Changes in hitherto relatively stable patterns of susceptibility among anaerobes may well necessitate an increase of sensitivity testing in diagnostic laboratories. Zentralbl Chir, 1982, 107(11), 639 - 47 {Infections with non-sporing anaerobic bacteria . Diagnostics, therapy and clinical importance}; Naumann G; The increasing significance of infections with non-sporing anaerobic bacteria is a very important problem for clinicians and microbiologists too . The author deals with the properties of anaerobic bacteria and gives a review of our present knowledge in the fields of clinical symptoms, the mechanisms of pathogenicity . Especially, emphasis is laid on the collection and transportation of specimens for anaerobic cultures . Possibilities of rapid laboratory diagnosis are described as well as the exact bacteriological diagnosis and the in-vitro testing in case of antimicrobial susceptibility . Remarks on the clinical significance and chemotherapy of anaerobic infections complete this review. Lab Anim, 1982 Jan, 16(1), 59 - 64 Association of germfree mice with intestinal microfloras obtained from "normal" mice; Koopman JP et al.; A cultured microflora obtained from the caecum of a "normal" mouse was given to 4 groups of germfree mice and was supplied 1x, 2x, 3x and 4x respectively at 5-day intervals . Another group received a 10(-7) dilution of the caecal flora while a group associated with an 'SPF' flora served as control . The difference (measured by 8 parameters) between mice supplied with the cultured flora or with a 10(-7) dilution, both given once only, was small . Supplying the flora 3x resulted in more 'normal' mice compared with mice which received the flora once or twice . The caeca of specified-pathogen-free mice contained more bacteria per gram (microscopic bacterial count), less aerobic and anaerobic bacteria per gram (viable counts), while the yield as percentage of the microscopic bacterial count was lower as compared with the group to which a cultured flora was supplied 4 times. Clin Ther, 1982, 5 Suppl A, 74 - 82 Comparison of cefotaxime with cefazolin for prophylaxis of vaginal or abdominal hysterectomy; Roy S et al.; One hundred fourteen women undergoing vaginal hysterectomy (n = 63) or abdominal hysterectomy (n = 51) were randomly allocated to one of three groups: regimen 1--cefotaxime perioperatively; regimen 2--cefotaxime perioperatively and for 24 hours postoperatively; or regimen 3--cefazolin perioperatively and for 24 hours postoperatively . Febrile morbidity was evaluated with respect to antibiotics, number of doses, type of procedure, operative time, estimated blood loss, and wound bacteriology . Of the patients who underwent vaginal hysterectomy, febrile morbidity occurred in three of 24 on regimen 1, one of 23 on regimen 2, and zero of 16 on regimen 3 . Of those patients who underwent abdominal hysterectomy, febrile morbidity occurred in three of 18 on regimen 1, zero of 19 on regimen 2, and two of 14 on regimen 3 . There were no significant differences among regimens in the incidence of febrile morbidity after vaginal or abdominal hysterectomy . Findings indicate, however, that febrile morbidity correlates with the type of procedure rather than with any of the other variables studied . Return of vaginal flora (aerobes, anaerobes, or mixed) was similar with all regimens . Cefotaxime was found to be as effective as cefazolin in reducing febrile morbidity. Clin Ther, 1982, 5 Suppl A, 26 - 31 Clinical comparison of cefotaxime versus the combination of gentamicin plus clindamycin in the treatment of polymicrobial soft-tissue surgical sepsis; Strom PR et al.; The safety and efficacy of cefotaxime versus a combination of gentamicin and clindamycin were compared in a prospective, randomized study of 98 surgical patients with polymicrobial soft-tissue infection or septicemia . Forty-nine patients received cefotaxime (20 mg/kg every six hours), and 49 received gentamicin (1 mg/kg every eight hours) plus clindamycin (5 mg/kg every six hours); all drugs were given intravenously . Overall, there was no statistical difference in clinical response to the two regimens, infection being eliminated in 73% of the patients treated with cefotaxime and 71% of those given gentamicin plus clindamycin . Adverse effects were mild and self-limited in both treatment groups, although three patients treated with gentamicin plus clindamycin experienced some loss of renal function . Most aerobic gram-negative rods were sensitive to both cefotaxime and gentamicin, but anaerobes were slightly more sensitive to clindamycin than to cefotaxime . Cefotaxime appeared to be at least as effective as gentamicin plus clindamycin in the treatment of polymicrobial soft-tissue infections and septicemia, and, in light of the loss of renal function associated with the gentamicin-clindamycin regimen, somewhat safer . The high failure rate among patients on both regimens with septicemia of unknown origin (five of the nine treated with cefotaxime and two of the four treated with gentamicin and clindamycin), however, indicates the critical role of surgical management in the treatment of polymicrobial soft-tissue sepsis. Arch Intern Med, 1981 Dec, 141(13), 1771 - 6 Empyema thoracis during a ten-year period . Analysis of 72 cases and comparison to a previous study (1952 to 1967); Varkey B et al.; In this series of 72 cases of empyema, 28 patients (38.8) had anaerobes isolated from their pleural fluid cultures . In 22 patients, anaerobes were the only isolates, and in six there were also aerobes . This observed frequency (38.8%) of anaerobic empyema is notably greater than the frequency noted in an earlier study (1952 to 1967) from the Veterans Administration Medical Center, Wood, Wis, while the contribution of various pathogenetic mechanisms was similar . Although closed chest tube drainage was instituted initially in 51 patients, 18 patients (35%) subsequently required additional procedures . The case-fatality ratio was 51.4% in this study compared with 46.6% in the earlier study . Twenty-two patients died during the same hospitalization period while the empyema was an active problem . Six (8.3%) of these empyema-related deaths occurred in patients without underlying disease, while 16 (22.2%) were in patients with underlying diseases. Zentralbl Bakteriol Mikrobiol Hyg {A}, 1981 Dec, 251(2), 248 - 62 {Effect of anaerobiosis in 6 blood-culture media on the recovery rate of aerobic microorganisms (author's transl)}; Abdou MA et al.; Commercially manufactured blood-culture bottles with 6 different culture media have been considered in this study . The bottles were respectively supplemented with 10% fresh human blood and inoculated with obligate aerobic and facultative anaerobic microorganisms known to cause bacteremia and fungemia . The inoculum size ranged from less than 10 to 10(2) CFU per blood-culture bottle . The study was carried out by alternately incubating one set of bottles anaerobically for two days before being vented, while the other set was vented immediately after inoculation . The effect of anaerobic and aerobic atmospheres on growth intensity, recovery rate and survival durability of the 11 microbial strains has been studied . The maintenance of anaerobic atmosphere for 2 days before venting the blood-culture bottles caused: a) 2 to 4 days delay in detecting nonfastidious bacteria and fungi; b) rapid death of acid-sensitive bacteria in poorly buffered culture media; c) inability of fastidious bacteria to grow in any of the 6 culture media . On the other hand venting the blood-culture bottles immediately after inoculation enabled: a) rapid detection of bacteria by an early subculture after 8 hours of incubation; b) diagnostic advantage of at least 2 days with rapidly growing bacteria which make more than 50% of the whole microbial spectrum; c) good growth of fastidious bacteria . Collectively, brain heart dipeptone broth proved to be the most effective culture medium for detection of obligate aerobic microorganisms responsible for bacteremia. Z Kinderchir, 1981 Nov, 34(3), 227 - 35 Tobramycin-clindamycin versus cephalothin-cephalexin in the treatment of appendicular peritonitis; Gripenberg L et al.; Forty-seven children, ages 1 to 14 years, with appendicular peritonitis were randomly divided into two groups: 27 were treated with the combination tobramycin-clindamycin and 20 with cephalothin followed by cephalexin . The overall rate of complications was 32% . Patients who had had their symptoms for less than 48 hours before being admitted to hospital had significantly fewer complications than those whose symptoms had lasted longer . Patients treated with tobramycin-clindamycin had significantly fewer wound infections . As clindamycin is effective against anaerobes this observation supports the view that anaerobes play an important role in the infectious complications in peritonitis . In this series, 12 species of aerobes and eight species of anaerobes were cultured from peritoneal fluid . In eight patients only one species was isolated; in the remaining 39 patients 29 different combinations of bacteria were encountered . Early diagnosis and administration of antibiotics preoperatively or during surgery, including clindamycin, metronidazol or tinidazol is recommended in the treatment of children with appendicular peritonitis. Antimicrob Agents Chemother, 1981 Nov, 20(5), 696 - 8 Evaluation of a direct blood culture disk diffusion antimicrobial susceptibility test; Doern GV et al.; A total of 556 unique blood culture isolates of nonfastidious aerobic and facultatively anaerobic bacteria were examined by direct and standardized disk susceptibility test methods (4,234 antibiotic-organism comparisons) . When discrepancies which could be accounted for by the variability inherent in disk diffusion susceptibility tests were excluded, the direct method demonstrated 96.8% overall agreement with the standardized method . A total of 1.6% minor, 1.5% major, and 0.1% very major discrepancies were noted. Clin Pediatr (Phila), 1981 Nov, 20(11), 748 - 50 Subcutaneous fat necrosis of the newborn; Mogilner BM et al.; A case of subcutaneous fat necrosis of the newborn is described . Severe perinatal asphyxia preceded the appearance of the skin lesions . Premature rupture of membranes and the presence of foul-smelling meconium raised the possibility of infection by anaerobes as an additional etiologic factor . The main hypotheses concerning the cause and pathogenesis of this condition are reviewed . The alarming clinical picture that stands in sharp contrast to the benign prognosis is stressed. Br J Cancer, 1981 Nov, 44(5), 741 - 5 Interaction of nitroimidazole drugs with DNA in vitro: structure-activity relationships; Knox RJ et al.; An electrolytic reduction system has been developed to model the cytotoxic action of a range of nitroimidazole drugs against DNA hypoxic cells or anaerobic microorganisms . THe degree of damage induced by these drugs (measured as the release of {14C}-dT from DNA) and their relative rates of reduction have been correlated with their redox potentials . The results show that the correlation of drug-induced damage and electron affinity is related to the amount of drug reduced, and supports the hypothesis that at the molecular level the cytotoxic mechanism of reduced nitroimidazoles is identical in hypoxic mammalian cells, bacteria and protozoa. Drug Intell Clin Pharm, 1981 Nov, 15(11), 838 - 46 Metronidazole (Flagyl IV, Searle); Stranz MH et al.; Metronidazole is a narrow spectrum antibiotic with undoubted efficacy against common anaerobic bacteria; resistance is unusual . Therapeutic concentrations of the drug are attained throughout most body compartments after either oral or intravenous administration . The limited side effects of metronidazole are generally tolerable, transient, or reversible . Clinically, metronidazole is as effective as clindamycin and probably chloramphenicol against anaerobes . It has a definite advantage over clindamycin in CNS infections since clindamycin does not penetrate the CSF well . Metronidazole has no irreversible hematologic toxicities, nor has pseudomembranous colitis been definitely attributed to intravenous use of the drug . Metronidazole may replace chloramphenicol for use in anaerobic infections since it lacks the predictable hematologic toxicity of the latter drug . It should also be useful in patients who fail to respond to clindamycin or who develop pseudomembranous colitis while receiving clindamycin . Problems with metronidazole include a complicated preparation procedure, and the high cost of the drug . The single major drawback to the use of metronidazole is uncertainty about its carcinogenic potential in humans . Metronidazole is carcinogenic in animals and mutagenic in vitro, but has not increased the incidence of cancer in humans followed for relatively short periods . Thus, the risk appears to be small . Still, the question will not be resolved for years because of the long latency periods involved in carcinogenesis . Until that time, metronidazole should be used conservatively. Rev Infect Dis, 1981 Nov-Dec, 3 suppl, S259 - 68 Antibiotic prophylaxis in cancer patients: regimens of oral, nonabsorbable antibiotics for prevention of infection during induction of remission; Bodey GP; The high frequency of complications caused by infections during therapy of malignant diseases has led to the development of prophylactic programs . The most effective prophylaxis has included the use of protected environments and antibiotic regimens (PEPA) . Most oral prophylactic regimens include vancomycin to provide coverage against aerobic, gram-positive cocci and some anaerobes . Regimens of nonabsorbable antibiotics are effective in eliminating the vast majority of bacteria from the stool, but the antifungal agents are less effective . However, once the antibiotic regimen is discontinued, organisms previously cultured will reappear . Several prospective, randomized studies have been conducted of patients with acute leukemia who are undergoing chemotherapy administered to induce remission . The frequency of complications caused by infection has been significantly lower for patients in the PEPA program than for controls . A recent study of patients with lymphoma has shown that patients in the PEPA program can tolerate higher doses of chemotherapy than can control patients and that they have lower frequency of complications caused by infection. Schweiz Med Wochenschr, 1981 Oct 17, 111(42), 1557 - 62 {Inquiry on the use of cephalosporins in Switzerland}; Keller H; In July of 1980 an inquiry was conducted on the use of cephalosporins (CS) in Swiss hospitals . 387 senior physicians answered the questionnaire with reference to the following points: -- Frequency of CS administration compared with the use of aminopenicillins and of combinations of several penicillins . -- Reasons for switching from one CS to another CS derivative . -- Major indications and principles of CS administration . -- Frequency of oral administration of CS . -- Use of CS in bacterial meningitis and in infections by anaerobic bacteria . -- Combination with aminoglycosides . -- Preference to particular CS derivatives . In the light of practical experience and a multitude of additional comments by the respondent physicians, an attempt is made to define guidelines for CS application. Sex Transm Dis, 1981 Oct-Dec, 8(4 suppl), 316 - 20 Current therapy of vulvovaginitis; Rein MF; Trichomoniasis is reliably treated with a single 2-g dose of metronidazole; however, with this regimen simultaneous treatment of sexual partners is particularly important . Trichomoniasis in pregnant women, who should not receive metronidazole, might be treated initially with clotrimazole vaginal suppositories, which appear to cure about 50% of cases . Topical antifungal agents of the imidazole class are superior to polyenes in treating vulvovaginal candidiasis . Boric acid powder applied intravaginally in gelatin capsules for 14 days appears as effective as imidazoles . Nonspecific vaginitis is now recognized as involving infection with anaerobic bacteria of the vaginal flora as well as Gardnerella vaginalis . The condition is most successfully treated with a seven-day course of metronidazole, which probably acts by eradicating the anaerobes . In addition, metabolites of metronidazole may act directly on G . vaginalis . Sulfanilamide-aminacrine-allantoin preparations are much less effective than specific therapies and have no role in the treatment of vulvovaginitis. Clin Pediatr (Phila), 1981 Oct, 20(10), 667 - 9 Pyogenic osteomyelitis versus pseudo-osteomyelitis in Gaucher's disease . Report of a case and review of the literature; Schubiner H et al.; Presented is a young girl with Gaucher's disease who developed acute bone pain accompanied by signs of inflammation and who was felt to have possible pyogenic osteomyelitis . The lack of significant pathogenic bacterial growth on culture and the findings at orthopedic surgery led the authors to conclude that this child probably represented a case of pseudo-osteomyelitis, but the isolation of an anaerobe from the operative culture of the involved bone leaves the exact diagnosis unclear . Since this child underwent an open surgical procedure, she was treated with antibiotics to prevent the possible development of chronic osteomyelitis . This anaerobic growth on culture, although strongly felt to be a contaminant, also played a role in this decision . She had an uneventful hospital course and subsequently has done well . It is suggested that great caution be taken before subjecting a patient with Gaucher's disease to orthopedic surgical procedures . If pyogenic osteomyelitis is strongly suspected, obtaining multiple blood cultures and culture by needle aspirate may be preferred over an open surgical procedure . The use of empiric antibiotic therapy without an attempt at further diagnosis is not recommended . If an orthopedic surgical procedure is necessary in a patient with Gaucher's disease, antibiotic coverage is indicated and long-term observation of the operative sight for drainage and/or other signs of chronic inflammatory changes in mandatory. J Clin Microbiol, 1981 Oct, 14(4), 389 - 92 Comparison of a slide blood culture system with a supplemented peptone broth culture method; Bryan LE; A slide blood culture system (Roche Diagnostics, Div . Hoffman-La Roche, Inc., Montreal, Canada; Roche BCB) was compared with a supplemented peptone broth Vacutainer method (Becton, Dickinson & Co., Rutherford, N.J.) on blood samples taken from the same 1,209 patients . Significantly more clinically important isolates were isolates with the Roche BCB system, and technical processing time was reduced . However, significantly more contaminants were isolated with the Roche BCB system, and it could not readily be adapted for anaerobic culture . Contamination was reduced by careful tightening of the slide to the bottle top to prevent any leakage . Overall, the BCB system is a satisfactory method for aerobic blood culture, markedly reducing technical processing time relative to most other blood culture methods. Arch Intern Med, 1981 Oct, 141(11), 1424 - 7 Metronidazole vs clindamycin treatment of anerobic pulmonary infection