J Biol Chem, 1991 Sep 15, 266(26), 17195 - 200 Staphylococcus aureus alpha-toxin . Dual mechanism of binding to target cells; Hildebrand A et al.; Staphylococcal alpha-toxin was radiolabeled to high specific radioactivity (1,500-3,000 Ci/mmol) under retention of its hemolytic activity . Binding studies with susceptible rabbit erythrocytes and highly resistant human erythrocytes revealed that binding of alpha-toxin to target cells can occur via two different mechanisms . Binding of alpha-toxin to rabbit erythrocytes initially involves specific binding sites and occurs at low concentrations, with half-maximal binding at 1-2 nM . In contrast, toxin binding to human erythrocytes is absorptive and nonspecific, in this case, significant binding as well as hemolysis occur only at alpha-toxin concentrations exceeding 1 microM . Autoradiographic analyses of membrane-associated alpha-toxin from either cell species proved that hemolysis was inevitably associated with the formation of toxin hexamers . Our data indicate that the high susceptibility of certain target cells toward alpha-toxin is caused by the presence of specific binding sites . However, membrane damage of both susceptible and nonsusceptible target cells occurs via a common mechanism involving toxin oligomerization and pore formation. Anal Chem, 1991 Sep 15, 63(18), 1978 - 83 Optimization of the fragmentation in a frit-fast atom bombardment ion source for the sequencing of peptides at the picomole level; Kassel DB et al.; Peptides derived from enzymatic digestions (cathepsin D and trypsin) were characterized and amino acid sequences determined by using their LC/MS spectra . A Frit-FAB interface that produces extensive peptide fragmentation and permits amino acid sequencing at the low picomole level is described for a model antigen, Staphylococcus aureus nuclease (Nase), and an enzyme of unknown structure, yeast aminopeptidase B . The amino acid sequences of peptides derived from digestion of Nase with cathepsin D (a relatively nonspecific endoprotease) were readily deduced and have provided insights into the nature of antigen processing . Frit-FAB LC/MS spectra of the Nase peptides contained a sufficient number of fragment ions to conclusively identify peptides with a mass below 2000 Da . Capillary LC/MS provided a means for the separation and identification of these enzymatically derived peptides in a fraction of the time that would have been required by gas-phase Edman sequence analysis . The optimized Frit-FAB experiment was consequently evaluated for the partial characterization of aminopeptidase B recently purified to homogeneity from Saccharomyces cerevisiae . Sequence-specific ions observed in the Frit-FAB mass spectra of these tryptic peptides were identical with those commonly observed in high-energy collision-induced dissociation (CID) spectra and included side-chain fragment ions that differentiated leucine from isoleucine . These fragment ions were used to deduce entire amino acid sequences for several of the tryptic peptides. FEMS Microbiol Lett, 1991 Sep 15, 67(1), 11 - 5 Identification of an insertion sequence, IS1081, in Mycobacterium bovis; Collins DM et al.; An insertion sequence, IS1081, in the genome of Mycobacterium bovis has been identified and sequenced . It is 1324 bp long with 15 bp inverted repeat ends and contains a large ORF . There are six copies of IS1081 in the genome of M . bovis and the element is also present in Mycobacterium tuberculosis . IS1081 is not closely related to other DNA elements described in actinomycetes but its putative transposase bears some resemblance to that of IS256 from Staphylococcus aureus . IS1081 may be useful for genetic manipulations and for developing a diagnostic test for bovine tuberculosis based on the polymerase chain reaction. Vet Surg, 1991 Sep-Oct, 20(5), 306 - 10 Effects of chlorhexidine gluconate and chlorous acid-chlorine dioxide on equine fibroblasts and Staphylococcus aureus; Redding WR et al.; Equine fibroblasts and Staphylococcus aureus were exposed for 30 minutes to six dilutions of chlorhexidine gluconate, a chlorous acid-chlorine dioxide irrigation solution, a chlorous acid-chlorine dioxide disinfectant, and phosphate buffered saline controls . Cell viability was determined by trypsinizing the cells, staining them with trypan blue, and counting cells that did not take the stain . All fibroblasts were killed when exposed to 1.0% and 0.5% chlorhexidine . The survival rate of fibroblasts increased linearly with decreasing concentrations of chlorhexidine gluconate, with a peak survival of 50% at 0.005% chlorhexidine . The chlorous acid-chlorine dioxide irrigation solution was the least toxic to fibroblasts, with survival rates equivalent to those of controls . The chlorous acid-chlorine dioxide disinfectant was 100% cytotoxic even when diluted 1:1 with phosphate buffered saline . S . aureus growth was inhibited by 1.0% and 0.5% chlorhexidine gluconate; concentrations of 0.05%, 0.01%, and 0.005% did not differ from sterile water controls . The chlorous acid-chlorine dioxide irrigation solution did not inhibit growth of S . aureus in brain-heart infusion broth . The chlorous acid-chlorine dioxide disinfectant inhibited growth of S . aureus. Rev Infect Dis, 1991 Sep-Oct, 13(5), 893 - 5 Detection of the source of recurrent Staphylococcus aureus bacteremia by ultrafast computerized tomography; McKinsey DS et al.; A patient with spina bifida secondary to an Arnold-Chiari deformity experienced seven episodes of sustained bacteremia due to Staphylococcus aureus over 2 years . Despite an extensive diagnostic evaluation the source of the recurrent bacteremia remained obscure . The patient's mother eventually recalled that a procedure for replacement of a ventriculoatrial shunt performed 16 years earlier had been complicated by retention of a shunt fragment in the bloodstream . Standard radiographic techniques failed to identify an intravascular foreign body; however, ultrafast computerized tomography of the heart demonstrated a density in the right atrium . Atriotomy was performed and a plastic catheter fragment was excised . Bacteremia has not recurred during a follow-up period of 24 months . Patients with recurrent unexplained bacteremia should be evaluated carefully for the presence of occult intravascular catheter fragments that may be retained after surgical procedures or intravascular instrumentation . Ultrafast computed tomographic scanning of the heart is a useful technique for detecting intracardiac catheter fragments. J Reprod Immunol, 1991 Sep, 20(3), 267 - 76 Detection of IL-6 in human milk and its involvement in IgA production; Saito S et al.; A large amount of interleukin-6 (IL-6) was found to be contained in human whey . The concentration of IL-6 in colostrum was significantly higher than that in serum or in milk taken 1 month after parturition . Colostrum contained many more mononuclear cells than late milk . In terms of the proportion of monocytes, T cells and B cells, however, there is no difference between colostrum and late milk . There is a significantly positive correlation between the concentration of IL-6 and the number of mononuclear cells in milk . This demonstrates that IL-6 in whey is derived in part from mononuclear cells . Stimulation of human milk mononuclear cells by Staphylococcus aureus Cowan I in the presence of anti-IL-6 antibody markedly decreased the production of IgA . This suggests that IL-6 contained in milk is closely associated with the local production of IgA in the breast. Nippon Kyobu Geka Gakkai Zasshi, 1991 Sep, 39(9), 1803 - 8 {A case report of early prosthetic valve endocarditis due to methicillin resistant Staphylococcus aureus infection--an experience of intraatrial implantation of mitral prosthesis with a Gore-Tex flange}; Murayama H et al.; A 60-year-old female with mitral stenosis developed prosthetic valve endocarditis due to methicillin resistant staphylococcus aureus septicemia 3 weeks after mitral valve replacement . In vitro test disclosed susceptibility to minocycline and clindamycin . Despite large amount of intravenous administration, progressive heart failure due to massive perivalvular leakage occurred as a consequence of persisting infection . An emergent operation revealed valve detachment of the posterior portion resulting from ring abscess formation . A mitral prosthesis with a Gore-Tex flange was implanted partially in the left atrium just above the mitral ring and sutured to the atrial wall . Postoperative relapse was not detected even after discontinuing antibiotics . Prosthetic valve endocarditis due to methicillin resistant staphylococcus aureus is highly resistant to antibiotic therapy and likely to develop valve ring abscess . Prompt surgical treatment is mandatory in this situation. J Appl Bacteriol, 1991 Sep, 71(3), 270 - 6 A nitrate reductase-based colorimetric assay for the study of bacterial adherence; Shoeb HA et al.; Washed intact cells of Escherichia coli and Staphylococcus aureus, grown under partial anaerobic conditions in nitrate media, reduced nitrate quantitatively when formate was used as a reducing substrate . Nitrate reductase was applied as an index for bacterial adherence to different target surfaces including uroepithelial cells, HeLa cells and fibrin clots . Nitrate reduction by adhered as well as control cells was determined by quantitative diazotization reaction for nitrite . Variations in the conditions which affect adherence gave rise to corresponding variations in the nitrate reduction index from which bacterial adherence can be conveniently determined under these conditions . This method is simple, reproducible and easy to perform in a short time. J Appl Bacteriol, 1991 Sep, 71(3), 239 - 43 Effect of some antibiotics and biocides on plasmid transfer in Staphylococcus aureus; al-Masaudi SB et al.; The effects of some antibiotics and biocides on the conjugative transfer of the Staphylococcus aureus gentamicin resistance plasmid pWG613 were investigated . Gentamicin and vancomycin were found to stimulate plasmid transfer frequency by 10- to 20-fold whereas methicillin and three inhibitors of protein synthesis each reduced it by various degrees . Most significantly, mupirocin inhibited plasmid transfer frequency by more than 1000-fold . All the biocides tested (cationic agents, sodium dodecyl sulphate and an organomercurial) reduced plasmid transfer. Antimicrob Agents Chemother, 1991 Sep, 35(9), 1928 - 30 Lack of homology of enterococci which have high-level resistance to trimethoprim with the dfrA gene of Staphylococcus aureus; Frosolono M et al.; Multiresistant enterococci were tested for susceptibility to trimethoprim (TMP) . Although most enterococci are inhibited by less than or equal to 1.0 microgram/ml, the MICs for 7 of 29 selected multiresistant isolates were greater than or equal to 8 micrograms/ml, including for two beta-lactamase positive (Bla+) strains, for which the MICs of TMP were greater than 1,000 micrograms/ml, and for another Bla+ strain, for which the MIC was 128 micrograms/ml . None of five isolates tested transferred TMP resistance and none of the resistant isolates hybridized to the dfrA gene of Staphylococcus aureus . Whether TMP resistance in enterococci is due to a mutation(s) or to acquisition of a new gene is not known . Acquisition of resistance to TMP is another example of the multiple antimicrobial resistance typically displayed by enterococci. Antimicrob Agents Chemother, 1991 Sep, 35(9), 1911 - 3 Emergence of quinolone resistance among clinical isolates of methicillin-resistant Staphylococcus aureus in Ontario, Canada; Harnett N et al.; One hundred two isolates of methicillin-resistant Staphylococcus aureus (MRSA) randomly selected from across the Canadian province of Ontario were tested for their susceptibility to ciprofloxacin, norfloxacin, and nalidixic acid by the agar dilution method . Forty-nine percent (50 of 102) had high levels of resistance to these quinolone compounds . For the 50 resistant isolates, ciprofloxacin and norfloxacin had high MICs for 90% of isolates (MIC90s) of 128 micrograms/ml and greater than 128 microgram/ml, respectively; for these isolates, the nalidixic acid MIC90 was greater than 640 micrograms/ml . The majority (98%) of the 50 isolates were also resistant to tobramycin (MIC90, greater than 128 micrograms/ml), while 42% of the isolates were resistant to gentamicin (MIC90, 64 micrograms/ml) . Quinolone-resistant MRSA isolates were susceptible to bacteriophages from several groups, indicating independent selection of resistant strains . These results suggest that a reappraisal of the use of fluoroquinolones against MRSA in Canada is necessary. Antimicrob Agents Chemother, 1991 Sep, 35(9), 1824 - 8 Bactericidal effects of antibiotics on slowly growing and nongrowing bacteria; Eng RH et al.; Antimicrobial agents are most often tested against bacteria in the log phase of multiplication to produce the maximum bactericidal effect . In an infection, bacteria may multiply less optimally . We examined the effects of several classes of antimicrobial agents to determine their actions on gram-positive and gram-negative bacteria during nongrowing and slowly growing phases . Only ciprofloxacin and ofloxacin exhibited bactericidal activity against nongrowing gram-negative bacteria, and no antibiotics were bactericidal (3-order-of-magnitude killing) against Staphylococcus aureus . For the very slowly growing gram-negative bacteria studied, gentamicin (an aminoglycoside), imipenem (a carbapenem), meropenem (a carbapenem), ciprofloxacin (a fluoroquinolone), and ofloxacin (a fluoroquinolone) exhibited up to 5.7 orders of magnitude more killing than piperacillin or cefotaxime . This is in contrast to optimally growing bacteria, in which a wide variety of antibiotic classes produced 99.9% killing . For the gram-positive and gram-negative bacteria we examined, antibiotic killing was greatly dependent on the growth rate . The clinical implications of slow killing by chemotherapeutic agents for established bacterial infections and infections involving foreign bodies are unknown. Antimicrob Agents Chemother, 1991 Sep, 35(9), 1799 - 803 In vitro studies of water activity and bacterial growth inhibition of sucrose-polyethylene glycol 400-hydrogen peroxide and xylose-polyethylene glycol 400-hydrogen peroxide pastes used to treat infected wounds; Ambrose U et al.; Water activity and bacterial growth inhibition have been studied in formulations comprising either sucrose or xylose along with polyethylene glycol 400 and hydrogen peroxide . The pastes are chemically stable for 6 months if stored at 2 to 8 degrees C and have been shown to lower water activity to levels below those essential for bacterial growth and to be bactericidal even when diluted up to 50% with serum . Of the organisms tested, Staphylococcus aureus proved the least susceptible to the bactericidal effects of these pastes, and candida and gram-negative organisms proved the most susceptible . Pastes without hydrogen peroxide were less rapidly bactericidal than pastes with hydrogen peroxide, while polyethylene glycol 400 itself was found to have considerable antimicrobial activity . It is suggested that sucrose paste may be of benefit as a treatment for infected and malodorous wounds. Vet Immunol Immunopathol, 1991 Sep, 29(3-4), 329 - 38 Activation of bovine neutrophils by recombinant bovine tumor necrosis factor-alpha; Chiang YW et al.; The in vitro effect of bovine recombinant tumor necrosis factor-alpha (rbTNF-alpha) on bovine neutrophil function and the possibility that rbTNF-alpha and recombinant bovine interferon-gamma (rbIFN-gamma) act synergistically were investigated . Treatment of neutrophils with rbTNF-alpha (0.05 micrograms/ml; approximately 50 U/ml) at 37 degrees C for 2.5 h resulted in enhancement of antibody independent neutrophil-mediated cytotoxicity (AINC) and inhibition of random migration and chemotaxis . The same treatment resulted in a slight decrease in iodination and cytochrome C reduction, but did not affect Staphylococcus aureus ingestion, or antibody dependent cell-mediated cytotoxicity . Kinetic and inhibitor studies indicated that the action of rbTNF-alpha was rapid and was independent of protein and RNA synthesis by neutrophils . Evaluation of the synergistic activities of rbTNF-alpha and rbIFN-gamma indicated that treatment of neutrophils with these two cytokines simultaneously resulted in additive enhancement of AINC and inhibition of random migration and chemotaxis . There was no additive effect of the two cytokines on inhibition of iodination or cytochrome C reduction. Orthopedics, 1991 Sep, 14(9), 981 - 4 Septic bursitis: experience in a community practice; Pien FD et al.; We reviewed 47 episodes of septic bursitis occurring in a private community medical practice . Most patients were male (85%), and roughly half (49%) the cases were related to recreational or occupational trauma . About 72% of cases were located in the olecranon bursa, while the remaining cases were prepatellar . Prepatellar bursitis patients were more likely to be hospitalized . Staphylococcus aureus was isolated from 70% of bursal fluid aspirations; other etiologic organisms included gram negative bacteria and Mycobacterium marinum . The majority of patients were able to be treated as outpatients with oral antibiotics . All patients were eventually cured without serious complications. Kyobu Geka, 1991 Sep, 44(10), 851 - 5 {A case report of total removal of infected pacemaker with cardiopulmonary bypass}; Toda S et al.; A successful removal of infected pacemaker with septicemia, pre-DIC state, and pneumonia is reported . A 44-year-old man received transvenous permanent pacemaker implantation through right subclavian region at 42 years of age . Two years and 3 months after implantation an abscess formed around the generator . Since incision and drainage were not effective, the generator was removed after 2 months (another pacemaker was reimplanted at the opposite side), and the initial pacing lead was cut after 3 months of initiation of the infection . But wound healing was not obtained and high fever-up occurred . Arterial blood culture showed septicemia caused by Staphylococcus aureus . He also suffered pre-DIC state and pneumonia . The end of the cut lead had fallen into the right ventricle . After general condition was recovered, the residual lead and the reimplanted pacemaker system were extirpated under cardiopulmonary bypass . And at the same time a new pacemaker system was implanted again . He was in good postoperative course, and he is up and well 8 months after operation. J Clin Pathol, 1991 Sep, 44(9), 772 - 4 Problems of thermonuclease detection for identifying Staphylococcus aureus in blood culture broths; Megson GM et al.; The detection of thermonuclease by the Oxford strain and eight clinical isolates of Staphylococcus aureus in a variety of bacteriological broths with and without added blood was examined using a toluidine blue-DNA-agar plate method . In Isosensitest, brain-heart infusion, tryptic soy, nutrient and gas-liquid chromatography broths (all of which do not contain liquoid) thermonuclease detection was uncomplicated . In Bactec broths (containing liquoid) detectable thermonuclease activity was greatly reduced in the absence of blood . The addition of 10% blood to the Bactec broths restored the activity . Liquoid was shown to be responsible for the inhibition of thermonuclease activity, and its effect could be neutralised by the addition of blood, albumin, or haemoglobin . In specimens containing no blood, or insufficient blood to neutralise the liquoid in culture broths, more has to be added to prevent false negative reporting of S aureus . This can be done after growth at the time of thermonuclease testing . Clinical consequences of delayed identification of S aureus in routine blood cultures may be serious . The application of the thermonuclease test to blood culture broths is both fast and specific. FASEB J, 1991 Sep, 5(12), 2706 - 12 Staphylococcal enterotoxin microbial superantigens; Johnson HM et al.; Staphylococcal enterotoxins are a family of structurally related proteins that are produced by Staphylococcus aureus . In addition to their role in the pathogenicity of food poisoning, these microbial superantigens have profound effects on the immune system, which makes them useful tools for understanding its mechanism of action . These molecules (24-30 kDa) are highly hydrophilic and exhibit low alpha helix and high beta pleated sheet content, suggesting a flexible, accessible structure . Staphylococcal enterotoxins are among the most potent activators of T lymphocytes known . The receptors for staphylococcal enterotoxins on antigen-presenting cells are major histocompatibility complex (MHC) class II molecules . Further, the alpha-helical regions of the class II molecule are essential for function and appear to interact directly with the NH2-terminal region of staphylococcal enterotoxins such as SEA . Recent studies have shown that a complex of staphylococcal enterotoxin and MHC class II molecules is required for binding to the V beta region of the T cell antigen receptor . Staphylococcal enterotoxin mitogenic activity is dependent on induction of interleukin 2, which may be intimately involved in the mechanism of toxicity . The mouse minor lymphocyte stimulating (M1s) "endogenous" self-superantigen has been shown to be a retroviral gene product, so this too is apparently a microbial superantigen . An understanding of the mechanisms of action of these microbial superantigens has implications for normal and pathological immune functions. Pediatr Nephrol, 1991 Sep, 5(5), 597 - 602 Increased monocyte-dependent suppression of polyclonal activation of B lymphocytes from cystinotic children; Pintos-Morell G et al.; In infantile cystinosis the amino acid cystine preferentially accumulates in phagocytic cells, polymorphonuclear leucocytes (PMN) and monocytes, rather than in lymphocytes . We previously described functional abnormalities in the oxidative metabolism and locomotion of cystinotic PMN and monocytes . The present study shows an abnormal lymphocyte polyclonal activation as evidenced by a decreased immunoglobulin (Ig) production and generation of Ig-containing cells (ICC) in cultures of peripheral blood mononuclear cells (PBMC) from cystinotic children upon stimulation with pokeweed mitogen and Staphylococcus aureus Cowan I . However, monocyte depletion from cystinotic PBMC fully reconstituted Ig production and ICC generation, indicating: (1) the presence of an increased monocyte-dependent suppression on lymphocyte polyclonal activation, and (2) that the intrinsic ability of cystinotic lymphocytes to respond to polyclonal stimulation was preserved . The increased cystinotic monocyte-dependent suppressive effect was not mediated by prostaglandin E2 (PGE2) since its production by cystinotic PBMC upon polyclonal activation was not different from that of controls . In addition, the sensitivity of cystinotic lymphocytes to the immunosuppressive effect of varying concentrations of exogenous PGE2 was similar to that of controls . Finally, indomethacin and 2-mercaptoethanol, two agents able to scavenge hydroxyl (.OH) radicals, restored Ig production by cystinotic PBMC, suggesting a role for reactive oxygen species in the increased cystinotic monocyte-dependent suppression. Eur J Immunol, 1991 Sep, 21(9), 2269 - 72 Differential migration of T and B cells during an acute inflammatory response; Meeusen E et al.; Inflammation in the liver and mammary glands of sheep caused by challenge infection with Taenia hydatigena or infusion of killed Staphylococcus aureus, respectively were characterized by the recruitment of both T and B cells . The patterns of migration of these two major lymphocyte subpopulations were distinctly different . While T cells seemed to migrate out of existing, flat endothelium-lined blood vessels resulting in a diffuse distribution at the sites of inflammation, B cells were characteristically present as clusters of tightly packed cells at restricted sites in the inflamed tissue . Within these B cell clusters distinct capillary vessels lined with plumb endothelial cells were always present suggesting that they were the sites of intense migration of B cells originating from the draining lymph nodes . These results indicate differential regulation of adhesion molecules on B and T cells and/or their ligands on endothelium during acute inflammatory reactions. J Gen Virol, 1991 Sep, 72 ( Pt 9), 2239 - 42 Outer capsid protein heterogeneity of rice dwarf phytoreovirus; Suzuki N et al.; The 46K outer capsid protein encoded by RNA segment S8 and the 42K polypeptide, previously thought to be the segment S9-encoded structural protein, were isolated from a rice dwarf phytoreovirus purified preparation, and then analysed by peptide mapping and electroblot-ELISA . Staphylococcus aureus V8 protease peptide mapping patterns of the 42K and 46K proteins were similar . Two monoclonal antibodies (MAbs), obtained after immunization with virus particles dissociated by 0.1% SDS, were each specific for both the 42K and 46K proteins . Furthermore, the MAbs bound common peptide fragments which were generated by digestion of the 42K and 46K proteins with V8 protease or proteinase K . These results strongly suggest that the 42K protein is not a gene product of S9 but a product overlapping with the 46K outer capsid protein . Whether the two proteins are functionally distinct remains to be determined. Clin Exp Immunol, 1991 Sep, 85(3), 386 - 91 Impaired tumour necrosis factor-alpha (TNF-alpha) production and abnormal B cell response to TNF-alpha in patients with systemic lupus erythematosus (SLE); Mitamura K et al.; We examined the TNF-alpha activity in culture supernatants of monocytes isolated from the peripheral blood of patients with SLE and of normal individuals . The monocytes from patients with SLE stimulated with silica particles, lipopolysaccharide or Staphylococcus aureus Cowan 1 secreted significantly lower amounts of TNF-alpha than did normal monocytes . A decreased TNF mRNA expression was observed in peripheral blood mononuclear cells stimulated by mitogens from patients with SLE . Furthermore, we examined the effect of recombinant TNF-alpha (rTNF-alpha) on the B cell function in SLE patients . rTNF-alpha inhibited the spontaneous B cell proliferation of SLE, but tended to enhance the normal B cell proliferation . Spontaneous IgM production from SLE B cells was inhibited by rTNF-alpha, but that from normal B cells was not . Spontaneous IgG production was unaffected by rTNF-alpha . Also, rTNF-alpha did not affect the viability of B cells . These findings suggest that an impaired TNF-alpha production and an abnormal B cell response to TNF-alpha play a role in the immunological dysfunction in patients with SLE. J Bone Joint Surg Am, 1991 Sep, 73(8), 1200 - 7 The importance of positive bacterial cultures of specimens obtained during clean orthopaedic operations; Dietz FR et al.; Microbiological cultures of specimens of tissue and of fluids from the wound in forty patients who had had consecutive clean, elective orthopaedic operations (excluding total joint replacements) and had not received antibiotics preoperatively were analyzed . Of the forty patients, twenty-three (58 per cent) had a positive culture on at least one of the media that were used and seventeen (43 per cent) had negative cultures . Of the forty specimens that were obtained from swabbing of the wound, eight (20 per cent) were positive on culture, compared with twenty (50 per cent) that were obtained from biopsy of tissue . Of these twenty-eight positive cultures, thirteen (46 per cent) were on routine blood-agar plates and fifteen (54 per cent), in broth only . Of the thirty-three bacterial organisms that were identified in the twenty-eight positive cultures of the wound, nineteen (58 per cent) were coagulase-negative Staphylococcus; eight (24 per cent), Propionibacterium acnes; two (6 per cent), Peptostreptococcus; and four (12 per cent), miscellaneous organisms . In all of the positive cultures on the blood-agar plates, except in those showing Propionibacterium acnes, there were five colonies or fewer . One patient had a clinical infection with Staphylococcus aureus that developed later, but the initial cultures of the wound had been positive for Staphylococcus epidermidis only . None of the bacteria that grew on culture were Staphylococcus aureus or the less common pathogenic gram-negative bacteria, such as Escherichia coli, Pseudomonas, or Klebsiella.(ABSTRACT TRUNCATED AT 250 WORDS) Am J Kidney Dis, 1991 Sep, 18(3), 344 - 8 Risk factors for tunnel infections in continuous peritoneal dialysis; Holley JL et al.; Little data are available about risk factors for peritoneal catheter subcutaneous tunnel infection . Therefore, we analyzed tunnel infections occurring in our program over a 10.5-year period . One hundred twenty-nine tunnel infections occurred in 92 of 411 patients (22%) on peritoneal dialysis for a mean of 19 +/- 19 months . Tunnel infection rate was 0.19 per year . By 1 year, 15% of patients had a tunnel infection, and by 2 years, 23% . Tunnel infection rates decreased with increasing time on peritoneal dialysis: 2.4 per year for patients on peritoneal dialysis less than 1 year, 0.8 per year for patients on dialysis 1 to 2 years, and 0.4 per year for patients on dialysis greater than 2 years (all different at P less than 0.01) . Organisms were cultured in 109 tunnel infections: gram-positive cocci in 77 episodes (71%) {Staphylococcus aureus 57, 52%}, and gram-negative bacilli in 24 episodes (22%) . Tunnel infection rates were higher in diabetics than in nondiabetics (0.27 per year v 0.16 per year, respectively; P less than 0.001 by life-table analysis of time to first infection) and also higher in women than in men (0.23 per year v 0.17 per year, P less than 0.001) . Tunnel infection rates were 0.35 per year for diabetic women, 0.20 per year for diabetic men, 0.18 per year for nondiabetic women, and 0.15 per year for nondiabetic men (groups different, P less than 0.001) . Race and age were similar in patients with and without tunnel infections . Catheter loss was 80% when tunnel infection was associated with peritonitis and 40% when tunnel infection alone was present (P less than 0.001) . We conclude that the risk of tunnel infection is highest early in the course of peritoneal dialysis and that diabetic women, for unclear reasons, are at the highest risk. J Thorac Cardiovasc Surg, 1991 Sep, 102(3), 413 - 7 Diagnosis and management of purulent pericarditis . Experience with pericardiectomy; Majid AA et al.; Twelve cases of purulent pericarditis seen over 6 years are described . Staphylococcus aureus was the most common causative organism (six patients), and a respiratory infection was the most common preceding illness . The chest radiograph and echocardiogram were useful pointers to the diagnosis, but the electrocardiogram was not reliable . Antibiotics, surgical drainage, and pericardiectomy were used in all 12 cases . There was one death (8.3%), which occurred in a patient who was seen late . A review of the literature dealing with the diagnosis and management of this condition is presented . The importance of early diagnosis before a significant degree of cardiac tamponade occurs is noted . Although there is general agreement that surgical drainage is mandatory, the approach, methods of drainage, and extent of pericardial resection have been the subject of some discussion, and at least seven techniques are available . We conclude that pericardiectomy has a definite place in the management of purulent pericarditis. J Nucl Med, 1991 Sep, 32(9), 1791 - 3 Gallium-SPECT in the detection of prosthetic valve endocarditis and aortic ring abscess; O'Brien K et al.; A 52-yr-old man who had a bioprosthetic aortic valve developed Staphylococcus aureus bacteremia . Despite antibiotic therapy he had persistent pyrexia and developed new conduction system disturbances . Echocardiography did not demonstrate vegetations on the valve or an abscess, but gallium scintigraphy using SPECT clearly identified a focus of intense activity in the region of the aortic valve . The presence of valvular vegetations and a septal abscess was confirmed at autopsy . Gallium scintigraphy, using SPECT, provided a useful noninvasive method for the demonstration of endocarditis and the associated valve ring abscess. Blood, 1991 Sep 1, 78(5), 1338 - 46 An inherited defect of neutrophil motility and microfilamentous cytoskeleton associated with abnormalities in 47-Kd and 89-Kd proteins; Coates TD et al.; A 2-month-old male Tongan infant presented with fever, severe skin and mucosal infections, hepatosplenomegaly, thrombocytopenia, and normal neutrophil counts . While polymorphonuclear neutrophil (PMN) morphology was normal, several neutrophil motile functions were found to be altered in the patient . Furthermore, two siblings had died in infancy with a similar clinical picture, raising the possibility of an inherited neutrophil defect . Random migration and chemotaxis, assessed by the under agarose method, were profoundly impaired . Actin polymerization, as measured by flow cytometry of N-(7-nitrobenz-2-oxa-1,3-diazol-4-yl)phallacidin (NBD-phallacidin)-stained PMNs, showed lower basal F-actin and a 1.75-fold increase in response to 10(-7) mol/L formyl-methionyl-leucyl-phenylalanine (FMLP) compared with a 4.51-fold increase in control . Microscopic examination of NBD-phallacidin-stained PMN spread on glass showed decreased area of spreading and F-actin-rich filamentous projections distinct from control . The early phase of FMLP-induced right angle light scattering was absent, similar to the effect caused by cytochalasin-B (CB), an inhibitor of actin polymerization . Accordingly, FMLP induced secretion of elastase without the addition of CB . Staphylococcus aureus killing was 50% of control whereas superoxide production response to FMLP and surface expression of CD11b were greater than twice normal . Partial defects in actin polymerization and scatter were seen in the parents and release of elastase, in the absence of CB, was also increased in both parents . Sodium dodecyl sulfate-polyacrylamide electrophoresis of whole cell proteins from the patient showed a marked decrease in an 89-Kd protein (8% of control) and a marked increase in a 47-Kd protein (4.2-fold) . Both mother and father had decreased 89-Kd (77% and 42% of control) and increased 47-Kd proteins (2- and 3.4-fold), although neither had recurrent infections or chemotactic defects . These studies describe a new inherited actin dysfunction syndrome associated with severe propensity to fungal infection and draw attention to the proteins of apparent molecular weights of 89 Kd and 47 Kd, which may be of great importance in the regulation of actin polymerization in human PMNs. J Exp Med, 1991 Sep 1, 174(3), 673 - 81 Evidence that natural murine soluble interleukin 4 receptors may act as transport proteins; Fernandez-Botran R et al.; The present studies were undertaken to determine whether the interleukin 4 binding proteins (IL-4BPs) previously identified in the biological fluids of mice are soluble forms of IL-4Rs . We also studied the binding properties of IL-4BPs in order to gain insight into their physiological role in vivo . Affinity-purified IL-4BPs and recombinant soluble IL-4Rs generated similar one-dimensional (Cleveland) peptide maps after digestion with either Staphylococcus aureus V8 protease or trypsin, indicating structural similarities . Furthermore, a rat mAb directed against the murine IL-4Rs immunoprecipitated the IL-4BPs and completely inhibited binding of 125I-IL-4 to a purified preparation of IL-4BPs . Taken together these data indicate that the IL-4BPs are soluble IL-4Rs . At 4 degrees C the IL-4BPs competitively inhibited the binding of IL-4 to membrane IL-4Rs but their ability to prevent binding of IL-4 to cells at 37 degrees C, at the same concentrations, was significantly reduced . Kinetic binding studies of soluble IL-4BPs vs . membrane IL-4Rs disclosed important differences in their rates of dissociation from IL-4 . Whereas dissociation at 4 degrees C was slow for both, dissociation of IL-4 from IL-BPs at 37 degrees C was considerably faster (t 1/2 of 2 min) than dissociation of IL-4 from membrane IL-4Rs (t 1/2 of approximately 69 min) . Temperature-dependent changes in dissociation kinetics were reversible, and could not be accounted for by either inactivation of the IL-4BPs at 37 degrees C or receptor internalization . Additional experiments also demonstrated that when IL-4BPs bind to IL-4 at 37 degrees C, the IL-4/IL-4BPs complex can rapidly dissociate, allowing IL-4 to bind to membrane IL-4Rs . In addition, binding of IL-4 by the IL-4BPs protects IL-4 from proteolytic degradation . Taken together, these results suggest that the IL-4BPs are naturally occurring forms of soluble IL-4Rs and that some of their properties (fast dissociation kinetics and protection of IL-4 from proteolysis) are consistent with a potential role as carrier proteins for IL-4 in the circulation. Cancer Res, 1991 Sep 1, 51(17), 4624 - 30 Tumor promoter 12-O-tetradecanoylphorbol-13-acetate and sn-1,2-dioctanoylglycerol increase the phosphorylation of protein kinase C in cells; Molina CA et al.; Phosphorylation of protein kinase C (PKC) may be an important mode of regulation of this enzyme that plays a key role in mouse skin tumor promotion and in mammalian cell signal transduction . To investigate this possibility, PKC was specifically immunoprecipitated from Abelson murine leukemia virus-transformed normal rat kidney cells that had been metabolically labeled with {32P}orthophosphoric acid . The Mr 80,000 phosphoprotein that was specifically immunoprecipitated from Abelson murine leukemia virus-transformed normal rat kidney cells was found to be identical with purified rat brain PKC that had undergone cell-free autophosphorylation . This is based on comparisons of peptides generated by partial proteolysis with Staphylococcus aureus V8 protease by one-dimensional polyacrylamide-sodium dodecyl sulfate gel electrophoresis and of tryptic peptides by reversed-phase high-pressure liquid chromatography . These data are consistent with phosphorylation of PKC in cells having occurred via autophosphorylation . The autophosphorylation of PKC was stimulated by treatment of C3H 10T1/2 cells with the tumor promoter 12-O-tetradecanoylphorbol-13-acetate or sn-1,2-dioctanoylglycerol . Exposure of cells to 100 nM 12-O-tetradecanoylphorbol-13-acetate for 15 min increased the phosphorylation of PKC by 5-fold in the particulate fraction, while treatment with 100 microM dioctanoylglycerol enhanced phosphorylation of PKC only by 2-fold . Phosphorylation of PKC in response to activation may have significance for altering the sensitivity of PKC to proteolytic down-regulation and/or to subsequent activation. Spec Care Dentist, 1991 Sep-Oct, 11(5), 197 - 9 MRSA: an important consideration for geriatric dentistry practitioners; Staat RH et al.; Methicillin-resistant Staphylococcus aureus (MRSA) can cause life-threatening disease in older populations . MRSA is readily spread by patient to patient or by health care workers to patient contact . Implications for dental practitioners include the fact that they may be passive vectors for the disease and that dental treatment of patients with active MRSA infections must follow effective infection control practices. Ann Vasc Surg, 1991 Sep, 5(5), 408 - 12 Prevention of vascular graft infection by rifampin bonding to a gelatin-sealed Dacron graft; Goeau-Brissonniere O et al.; This study examines the efficacy of rifampin bonding to a gelatin-sealed knitted Dacron graft to prevent perioperative bacteremic vascular graft infection . Antibiotic bonding was obtained by soaking grafts for 15 minutes in a 1 mg/ml saline solution of rifampin at 37 degrees C . Nineteen dogs had thoracoabdominal aortic bypass: seven (group I) received a rifampin treated graft; six (group II) received an untreated gelatin-coated graft; and six (group III) received an uncoated Dacron graft . Two days later bacteremic challenge was produced by rapid intravenous injection of 5 x 10(5) colony forming units of methicillin resistant Staphylococcus aureus . Grafts were harvested five days after this challenge and cut into 10 fragments, each submitted to bacterial counts . Results were expressed as CFU/cm2 of graft material . In group I, no graft was infected, whereas all grafts in groups II and III were infected (p less than 0.05) . Median bacterial counts from the infected fragments (median +/- SD) were similar in groups II (2.5 x 10(5) CFU/cm2) and III (4 x 10(4) CFU/cm2) . Blood cultures at time of sacrifice were negative in all dogs in group I and positive in five of six dogs in groups II and III . Cultures of liver, spleen, kidney, and lung specimens were always negative in group I and positive in 22 of 24 specimens in group II and 23 of 24 specimens in group III . Soaking a gelatin-sealed Dacron graft in rifampin solution evidently prevents early bacteremic graft infection and secondary foci of infection in this model. Clin Ther, 1991 Sep-Oct, 13(5), 637 - 50 Treatment of pneumonia: new strategies for changing pathogens; Ashby BL; Changes in the etiologic agents that cause pneumonia pose new challenges for empiric antimicrobial therapy . Ofloxacin is a new oral quinolone antibiotic with good to excellent activity against many of the usual and atypical pulmonary pathogens . Clinical trials have demonstrated high clinical and microbiological cure rates with ofloxacin and comparable efficacy to standard antibiotics used to treat pneumonia . Compared with ciprofloxacin, ofloxacin provides greater bioavailability, extended inhibitory concentrations in the blood, similar activity against gram-negative pathogens, better activity against gram-positive bacteria, in vitro activity against atypical pathogens, renal elimination, and a lower potential for interactions with theophylline and caffeine . These advantages suggest that ofloxacin should be the first-choice quinolone when Staphylococcus aureus is suspected, when higher and prolonged serum and tissue concentrations are needed, and when the patient is also receiving theophylline . In addition, the substitution of a potent oral antibiotic such as ofloxacin for intravenous agents may enable some hospital patients to continue their therapy as outpatients, thus reducing health-care costs. Diagn Microbiol Infect Dis, 1991 Sep-Oct, 14(5), 451 - 5 Correlative interpretation of staphylococcal resistance to penicillinase-resistant penicillins by ceftizoxime disk susceptibility test using Showa disks; Yamane N et al.; The Showa disk susceptibility test (Showa Yakuhin Kako Company, Japan) was evaluated to discriminate between the strains of Staphylococcus aureus resistant to penicillinase-resistant penicillins (PRPs) and those susceptible . When we tested 129 PRP-resistant and 112 susceptible strains, many PRP-resistant strains were interpreted to be false susceptible to methicillin and oxacillin, especially when incubated at 37 degrees C . Growth at 30 degrees C and when NaCl was added to the medium improved the test reliability for detection of PRP resistance . Ceftizoxime disk (30 micrograms) susceptibility test results highly correlated with reference PRP resistance when incubated at 35 degrees C . All the PRP-resistant strains produced no zone of inhibition, whereas all of the PRP-susceptible strains were categorized as susceptible to ceftizoxime (greater than or equal to 22 mm, less than or equal to 3.13 micrograms/ml), for example, 100% correlation . It was concluded that the Showa ceftizoxime disk, in replacement of PRPs, will provide a reliable, alternative method to predict PRP resistance in S . aureus pending reevaluation of the Show PRP disk tests. Mikrobiol Zh, 1991 Sep-Oct, 53(5), 37 - 40 {The effect of the antibiotic AL-87 on the amino acid yield from Staphylococcus aureus 209P cells}; Snirnov VV et al.; Antibiotic AL-87 has been studied for its effect on the composition of intracellular free amino acids and of amino acids in culture fluid of Staphylococcus aureus 209 P . It is established that the content of amino acids in the culture fluid of S . aureus 209 P is doubled due to antibiotics, while the content of intracellular free amino acids considerably decreases . Spectrum of free amino acids of S . aureus 209 P is presented by 17 basic amino acids . When there is a sub-bacteriostatic concentration of the antibiotic in the medium all free amino acids tend to leave the cells, the content of aspartic acid, serine, threonine and leucine in the medium being increased . Data obtained when studying the effect of antibiotic AL-87 on the composition of free amino acids of Staphylococcus agree well with the previously obtained results from the study of the fatty acid composition of cells . In the light of these data it may be supposed that an increase of the membrane permeability and as a result of it an outlet of amino acids into the medium is one of constituents of the mechanism of antibiotic AL-87 action on Staphylococcus cells. J Med Assoc Thai, 1991 Sep, 74(9), 377 - 80 Determination of teichoic acid antibody for the diagnosis of pediatric staphylococcal infections; Thisyakorn U et al.; Determination of teichoic acid antibodies by Enzyme-linked Immunosorbent Assay (ELISA) was done in 39 patients with Staphylococcus aureus infections and 151 patients who did not have a history of serious staphylococcal infections . The latter who were treated for other diseases served as controls . Various levels of teichoic acid antibodies below 1:3,200 were detected in controls while significantly higher levels were seen in patients with Staphylococcus aureus infections. Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi, 1991 Sep-Oct, 32(5), 325 - 9 {Non-surgical treatment of spinal epidural abscesses: report of one case}; Lin CC et al.; Spinal epidural abscesses (SEA) are uncommon in children . This paper reported a two-year-old boy who was noted to have neck stiffness, with local tenderness posteriorly . Bacterial meningitis was suspected initially in terms of the finding of the cerebral spinal fluid; antibiotics were prescribed . Three days later another spinal tap was performed because of persistent high fever and irritability . A pus-like material drained out as the needle punctured into the spinal region . A magnetic resonance image (MRI) scan of the spine revealed a SEA, with extensive involvement from the second cervical spine to the lumbosacral spine region . Culture of the pus, as well as the blood and CSF, were positive for Staphylococcus aureus . Because of extensive involvement of the spinal epidural space, the patient was again given antibiotics: Prostaphllin and Amikin intravenously for six weeks instead of laminectomy . Then the oral antibiotic (Keflex) was given to the patient for another three months after the boy was discharged from the hospital . A review of the literature shows the incidence of SEA to be increasing and the bacterial spectra to be broadening because of increasing use of immunosuppressing drugs or antibiotics, and the increase in numbers of immunecompromised patient . The clinical symptoms and signs of the SEA were non-specific, but SEA can be early diagnosed by computurized tomography (CT) scan or MRI scan with caution . The literature suggests that, if the patient's condition fits the criteria for non-surgical treatment, antibiotic therapy is the first choice for preventing the complication of spinal deformity, especially in children. Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi, 1991 Sep-Oct, 32(5), 297 - 302 {Comparison of rapid latex and conventional methods for the identification of Staphylococcus aureus}; Chen CH et al.; Rapid latex agglutination assay, staphaurex (Wellcome Diagnostics) was compared with the tube coagulase, thermo-stable nuclease, deoxyribonuclease and mannitol fermentation test for the identification of Staphylococcus aureus . A total of 277 clinical isolates of Staphylococcus aureus, 201 Staphylococcus epidermidis, and 25 Staphylococcus saprophyticus were tested . The results showed that sensitivities were: staphaurex, 99.6%; rabbit plasma, 99.6%; human plasma, 99.2%; thermostable nuclease, 100%; deoxyribonuclease, 100%; mannitol fermentation, 98.9%; as for specificities results showed: staphaurex, 96.6%; rabbit plasma 100%; human plasma, 100%; thermo-stable nuclease, 98.7%; deoxyribonuclease 95.7%; mannitol fermentation, 91.1%; respectively . In our study, staphaurex is recommended because it is simple to operate, save in time and economic in cost. Nippon Saikingaku Zasshi, 1991 Sep, 46(5), 855 - 60 {Cross reactive antigens of Acholeplasma laidlawii and L-form of Staphylococcus aureus}; Kawashima T et al.; We demonstrated that the membrane of Acholeplasma laidlawii PG8 and L-form of Staphylococcus aureus, both of which induce cellular immunity in BALB/c mice, were antigenically related each other . Foodpad responses of the mice immunized with a mixture of either antigen and Freund's complete adjuvant showed clearly a cross reaction when challenged with the other antigen . Cross responses to incorporate 3H-thymidine to the spleen lymphocytes of the mice immunized with either antigen occurred in the presence of the other antigen . Furthermore, the purified T cells, but not B cells, of the spleen were activated in the presence of antigen-presenting cells . These antigens existing in the membrane fractions of both microorganisms were purified by Razin's method . Finally, these membrane components of A . laidlawii and L-form of S . aureus were subjected to gel electrophoresis and transferring to nitrocellulose membrane and used to stimulate the spleen lymphocytes of the mice immunized with A . laidlawii or of non-immunized mice . The fractions representing molecular weights of approximately 45 kD, 25 kD, and 13 kD of both microorganisms consistently stimulated the lymphocytes of the immunized mice but not those of non-immunized mice. Nippon Saikingaku Zasshi, 1991 Sep, 46(5), 839 - 45 {Antibacterial and bactericidal activities of tea extracts and catechins against methicillin resistant Staphylococcus aureus}; Toda M et al.; We examined tea extract, (-) epigallocatechin gallate (EGCg) and theaflavin digallate (TF3) for their antibacterial and bactericidal activities against methicillin resistant Staphylococcus aureus (MRSA) and food poisoning strains of S . aureus . Twenty percent tea extract (50 microliters), EGCg (63 micrograms) and TF3 (125 micrograms) added to one ml of culture medium each inhibited the growth of all strains of MRSA and food poisoning S . aureus tested . Tea extract showed also a bactericidal activity against MRSA even at the same concentration of as in ordinarily brewed tea . EGCg at a concentration of 250 micrograms/ml showed a bactericidal activity against MRSA but not against food poisoning S . aureus, but at 500 micrograms/ml reduced markedly the viable number within 48h . These results suggest that tea and catechin can be used as prophylactic agents against MRSA infection. Immunopharmacology, 1991 Sep-Oct, 22(2), 107 - 13 Human mononuclear cell chemiluminescence and interleukin-1 release induced by Staphylococcus aureus protein A; Olsen UB; Staphylococcus aureus protein A (SpA) is shown to induce a temporary chemiluminescence (CL)-response of human peripheral blood mononuclear cells . Maximal activity of SpA is observed at 3 micrograms/ml and EC50 is about 1 microgram/ml . The CL response depends on extracellular calcium, and moreover is inhibited by pretreating cells with rabbit-anti-human IgG's . From glass-adhered monocytes, SpA alone (3 micrograms/ml) did not consistently affect the generation of immunoreactive interleukin-1 (IL-1) . However, SpA and endotoxin (1 micrograms/ml) showed a marked synergistic effect on IL-1 release . The results suggest that SpA interacts with membrane-bound Ig molecules endowed with receptor functions . The CL response may be envisaged as a result of early transmembrane signalling events presumably taking place in monocytes . Apparently, hereby, the cells become primed for endotoxin-triggered IL-1 release. Rev Infect Dis, 1991 Sep-Oct, 13 Suppl 10, S869 - 73 Antibiotic prophylaxis in clean surgery: peripheral vascular surgery, noncardiovascular thoracic surgery, herniorrhaphy, and mastectomy; Hopkins CC; Studies published in the English-language literature on the use of prophylactic systemic antibiotics in vascular surgery, noncardiovascular thoracic surgery, mastectomy, and herniorrhaphy were reviewed . The effectiveness of antibiotic prophylaxis in preventing deep and superficial wound infections in peripheral vascular surgery appears to be well documented, especially if prophylaxis is directed against Staphylococcus aureus . In clean thoracic surgery the evidence is equivocal, and no studies have sufficient statistical power to eliminate the possibility even of a 50% reduction in incidence . In herniorrhaphy and mastectomy some evidence from a much more powerful study suggests that antibiotic prophylaxis may result in a decrease of up to 50% in wound infections, but whether these data can be generalized uncritically to all clean wounds is still a matter of debate . Accordingly, only guarded recommendations can be made regarding the use of prophylactic antibiotics in procedures associated with a very low risk of serious infection. Rev Infect Dis, 1991 Sep-Oct, 13 Suppl 10, S847 - 57 Antibiotic prophylaxis in trauma: penetrating abdominal injuries and open fractures; Dellinger EP; Infection is an important cause of late morbidity and mortality following traumatic injury . As part of a coordinated treatment effort for the injured patient, preventive antibiotic use can reduce subsequent infectious complications . Available evidence supports the use of antibiotic(s) with activity against both aerobic and anaerobic enteric pathogens for patients with penetrating abdominal injuries and bowel penetration . Patients with open fractures benefit from the use of an antibiotic with activity against Staphylococcus aureus . Data on the ideal dose and duration of antibiotic administration in these situations are incomplete . It is likely that the best results will be obtained with early parenteral administration of large doses of the chosen antibiotic continuing for less than or equal to 24 hours . For injuries other than penetrating abdominal wounds and open fractures, definitive information is not available. Vet Pathol, 1991 Sep, 28(5), 419 - 27 Heterophil function in healthy chickens and in chickens with experimentally induced staphylococcal tenosynovitis; Andreasen CB et al.; Heterophil function was evaluated in 16 healthy chickens and in 46 chickens with experimentally induced staphylococcal tenosynovitis . In paired blood samples, heterophils from chickens with tenosynovitis had a significant increase in adherence, chemotaxis, phagocytosis, and bacterial killing of Staphylococcus aureus compared to heterophils from healthy chickens . The percent adherence of heterophils to nylon fiber columns increased significantly from a 78.4% mean +/- 6.6% standard deviation to 87.6% +/- 3.2% after induction of staphylococcal tenosynovitis . Heterophil movement following in vitro exposure to saline or endotoxin was increased in chickens with tenosynovitis; 3 +/- 1 heterophils/0.25 mm2 to 10 +/- 6 heterophils/0.25 mm2 and 136 +/- 29 heterophils/0.25 mm2 to 340 +/- 74 heterophils/0.25 mm2, respectively . Endotoxin-activated serum was chemoattractive for heterophils from all chickens . Flow cytometry was used to define the heterophil population on light scatter histograms, evaluate individual cell phagocytosis of latex beads, and quantitate the number of beads phagocytosed per heterophil . When incubated with increased numbers of beads, only heterophils from chickens with tenosynovitis phagocytosed higher numbers of beads . At heterophil to bead ratios of 1:10, the percentage of heterophils that phagocytosed beads increased from baseline values of 37.8% +/- 9.0% to post-infection values of 67.3% +/- 7.5% . Using 1:20 heterophil to bead ratios, heterophil phagocytosis increased from 38.7% +/- 9.9% to post-infection values of 79.8% +/- 7.3% . Heterophils from all chickens were able to phagocytose and kill log phase staphylococcal bacteria . After phagocytosis, the heterophils from chickens with staphylococcal tenosynovitis rapidly decreased the number of viable bacterial colony forming-units per milliliter by approximately one log.(ABSTRACT TRUNCATED AT 250 WORDS) Conn Med, 1991 Sep, 55(9), 507 - 10 The emergence of methicillin resistant Staphylococcus aureus in extended care facilities in northern Connecticut between 1986 and 1990; Rank EL; Methicillin resistant Staphylococcus aureus (MRSA) is recognized as a pathogen of significant morbidity in hospital facilities . The microorganism can also be recovered from clinical specimens taken from patients who are residents of extended care facilities (ECFs) . This report is a five-year retrospective review of the emergence and spread of MRSA isolates within ECFs located in north central Connecticut and their susceptibility profile over that time span. Int J Pediatr Otorhinolaryngol, 1991 Sep, 22(2), 151 - 60 Bacteriological nasal flora in newborns indicating health and/or development of infection; Cvetnic V et al.; During delivery, a fetus otherwise sterile during the intrauterine life, comes in contact with bacterial flora of the mother's birth canal, and then also with the ward personnel's skin and respiratory system flora . Due to the absence of competitive bacteriological flora, the nasal cavity is gradually colonized by microorganisms, especially those with a capacity of adhesion to epithelial cells of respiratory nasal mucosa . Bacteriological flora of the newborn's nasal flora was observed on days 1 and 3 postpartum, in an attempt to determine whether a finding of pathogenic bacterial flora in newborn's nasal mucosa indicates a localized infection only or points to the possible development of generalized infection . Bacteriological nasal flora was monitored in infants born by spontaneous delivery and in those born by cesarean section . In mothers of infants born by spontaneous delivery, bacteriological flora from the cervix uteri was investigated . Results of the study performed by usual methods revealed Escherichia coli and Staphylococcus aureus to prevail in the pathogenic flora . Gram-negative microorganisms were found to be good indicators of local infection of newborn's nasal mucosa, regardless of the absence of clinical symptoms. Vet Immunol Immunopathol, 1991 Sep, 29(3-4), 239 - 50 Differential enhancement and distribution of antigen-specific cells in various lymph nodes in response to locally inoculated bacterial antigens; Dobrzanski MJ et al.; The proliferation responses of antigen-specific lymphocytes from various anatomical sites were studied in dairy goats locally immunized with heat-killed Staphylococcus aureus (HKS) . Animals were inoculated three times subcutaneously in the right udder with HKS at 1 month intervals . One week following the last inoculation, prescapular, mesenteric and ipsilateral (draining) and contralateral (non-draining) suprammammary lymph nodes were collected and the cells assayed in 3- and 6-day cultures to determine the immune proliferative responses of antigen-specific lymphocytes to HKS and the polyclonal T cell mitogen phytohemagglutinin (PHA) . The cells from draining and non-draining supramammary lymph nodes responded to HKS in 3-day cultures . Peripheral lymph nodes, such as the prescapular, showed similar responses . In contrast, mesenteric lymph nodes responded optimally in 6-day cultures, notably to lower concentrations of the antigen . Cells from all lymph nodes tested showed increased responses to PHA in immunized animals, although non-draining lymph nodes demonstrated a greater response to the T cell mitogen than those of draining lymph nodes . These results suggest that unilateral introduction of Staphylococcus cell antigens to the supramammary region can induce an anamnestic response in ipsilateral as well as contralateral supramammary lymph nodes and other distant peripheral lymphoid organs . Furthermore, these data indicate that cells from intestinal lymph nodes respond differently from those of peripheral lymph nodes, suggesting the presence of a unique gastrointestinal lymphoid cell circulation in goats . Concomitant peripheral responses may be attributed to memory cell migration or to antigen leakage and relocation to distant sites from the inoculated region . Analysis with PHA suggests a difference in general responsiveness and perhaps, immunocompetence, by lymphocyte populations in various lymphoid tissues of immunized animals. Scand J Immunol, 1991 Sep, 34(3), 273 - 83 The role of CD45RA on human B-cell function: anti-CD45RA antibody (anti-2H4) inhibits the activation of resting B cells and antibody production of activated B cells independently in humans; Morikawa K et al.; Anti-CD45RA antibody defined by anti-2H4 monoclonal antibody has been reported to split CD4+T cells into two distinct subpopulations . CD45RA antigen is present on the surface of virtually more than 95% B lymphocytes in the purified tonsillar B-cell preparations . We examined the role of CD45RA antigen on human B-cell function using this antibody . The addition to anti-2H4 to tonsillar B cells inhibited the proliferative response induced by Staphylococcus aureus Cowan strain I(SAC) in a dose-dependent manner . Kinetic analysis indicated that anti-2H4 exerted its inhibitory effect when added within the first 24 h of culture initiation during a 72-h culture period . Anti-2H4 inhibited the transferrin receptor expression without interfering with the expression of the IL-2 receptor on SAC-stimulated B cells in a short-term culture . Anti-2H4 blocked the progress of SAC-stimulated B cells from the G1 to S phase of the cell cycle . These events suggested that anti-CD45RA MoAb inhibited the proliferative response by directly acting on B cells in the G1 phase . In addition, anti-CD45RA antibody also had a suppressive effect on early phase of B-cell differentiation . This effect appeared to be independent of its suppressive effect on proliferation, because anti-CD45RA did not inhibit the proliferative response of preactivated B cells with lymphokines . These studies suggested that the restricted epitope recognized by anti-2H4 antibody may be directly involved in regulatory function on B cells. J Hosp Infect, 1991 Sep, 19(1), 5 - 16 A maternity hospital outbreak of methicillin-resistant Staphylococcus aureus; Moore EP et al.; A maternity hospital outbreak of methicillin-resistant Staphylococcus aureus with a strain other than EMRSA-1 is described . In contrast to previously documented outbreaks, which have usually centered on special care baby units, this outbreak mainly involved the routine ante-natal and postnatal wards . Thirty-seven mothers, 18 babies and nine staff were affected over a 6-week period . The high turnover of very mobile maternity patients and the open-plan design of the hospital influenced the course of the outbreak and adversely affected implementation of infection control measures . Significant environmental contamination and a very high rate of maternal perineal MRSA colonization were notable epidemiological features. J Hosp Infect, 1991 Sep, 19(1), 41 - 8 Inter-strain comparison by pyrolysis mass spectrometry in the investigation of Staphylococcus aureus nosocomial infection; Gould FK et al.; Pyrolysis mass spectrometry (PyMS) was used to examine isolates of Staphylococcus aureus from an outbreak of wound infections on a cardiothoracic surgical unit, some of which were thought to have been related to a point-source in the operating theatre . The PyMS results were compared with the results of phage typing . Both methods suggested that a single strain of S . aureus, of phage pattern 29/52/52A/79/80/81, was responsible for some of the wound infections, but PyMS also identified two patients with phage non-typable isolates . Phage typing indicated four staff members as possible carriers of the epidemic strain, but PyMS indicated only two . Epidemiological enquiry confirmed that one of the two members of staff identified by both methods was likely to have been the source of the theatre-based infection . PyMS is a rapid and relatively inexpensive technique for the investigation of nosocomial S . aureus infection and was more discriminatory than phage typing in this instance. J Hosp Infect, 1991 Sep, 19(1), 17 - 24 Carriage and community treatment of methicillin-resistant Staphylococcus aureus: what happens to colonized patients after discharge? Hicks NR, Moore EP, Williams EW. During a maternity hospital outbreak of colonization/infection due to methicillin-resistant Staphylococcus aureus (MRSA), mothers and babies from 35 families were known to have been discharged colonized with MRSA . Thirty-two of these families were followed up by screening in the community . After 4 weeks, carriage was still detectable in 22 families . The ten families in which carriage was no longer detectable had MRSA isolated at discharge from enrichment culture only . All of the 11 families who had MRSA isolated on direct culture at discharge continued to carry MRSA . Mothers and babies from the 22 families still carrying MRSA at 4 weeks were offered topical treatment . Carriage persisted in ten of these families despite treatment . The most common site of persistent carriage was the perineum in mothers and the throat in infants. J Hosp Infect, 1991 Sep, 19 Suppl B, 41 - 6 The use of nasal mupirocin ointment to prevent Staphylococcus aureus bacteraemias in haemodialysis patients: an analysis of cost-effectiveness; Boelaert JR et al.; Nasal carriage of Staphylococcus aureus is a risk factor for the development of infections caused by S . aureus in haemodialysis patients . This study compared the incidence of bacteraemia caused by S . aureus during 6 months of use of nasal 2% calcium mupirocin ('Nasal Bactroban') 3-times a week for nasal carriers with the incidence observed previously in the same dialysis unit without the use of mupirocin . Nasal mupirocin led to the total eradication of nasal carriage of S . aureus, a 4.26-fold reduction in the incidence of S . aureus bacteraemia, and a substantial cost saving . After a cumulative experience of nasal mupirocin in haemodialysis patients of more than 43 patient-years, the development of mupirocin resistance was not observed. J Hosp Infect, 1991 Sep, 19 Suppl B, 19 - 25 The antimicrobial activity of mupirocin--an update on resistance; Slocombe B et al.; Mupirocin (pseudomonic acid A) has a novel chemical structure that is unrelated to any other known class of antibiotic, and possesses a unique mode of action . As a consequence, mupirocin lacks cross-resistance with other antibacterial agents and exhibits activity against strains of bacteria that are multiresistant . The selection in vitro of resistant variants of Staphylococcus aureus is slow, which is reflected in the low incidence of mupirocin resistance encountered in clinical practice . Pulse field gel electrophoresis studies on S . aureus highly resistant to mupirocin, have confirmed the presence of a large plasmid in the majority, but not all, of the isolates . Restriction endonuclease digests of the large plasmid DNA, and DNA hybridization studies with a non-radiolabelled probe constructed from total plasmid DNA, have shown that there were marked differences in plasmid types between isolates from different locations, but general similarities between plasmid types isolated from the same location. Microb Pathog, 1991 Sep, 11(3), 211 - 20 A periodate-sensitive anti-phagocytic surface structure, induced by growth in milk whey, on Staphylococcus aureus isolated from bovine mastitis; Hallen Sandgren C et al.; The phagocytic and chemiluminescent activity of purified bovine neutrophils in response to two Staphylococcus aureus strains isolated from mastitic bovine milk and grown in milk whey was studied . The activity was significantly reduced compared with the response elicited by the same strains grown in tryptic soy broth (TSB) . A mild periodate treatment of the milk whey-grown strains resulted in a significant increase of both chemiluminescence and phagocytosis, whereas trypsin, subtilisin or papain treatment had no effect . The decreased binding of complement factor C3 to milk-whey-grown bacteria was restored to the level of TSB-grown homologous organisms by periodate treatment . Moreover, this treatment, but not treatment with trypsin, increased the surface hydrophobicity of milk-whey-grown bacteria . The chemiluminescent activity was as high towards heat-killed as towards live bacteria . Also, incubation of heat-killed TSB-grown bacteria in milk whey did not alter the chemiluminescent response, indicating that the reduced neutrophil activity towards milk-whey-grown bacteria was not due to binding of milk components to the microorganisms . These results strongly suggest that bovine mastitis S . aureus strains grown in milk whey produce an anti-phagocytic surface structure . This structure is heat- and protease-resistant and renders the bacterial surface hydrophilic . The anti-phagocytic material is altered or, more likely, released from the bacterial surface on periodate treatment and is probably of carbohydrate nature. Microbiologia, 1991 Sep, 7(2), 113 - 9 Inhibition of the degranulation and myeloperoxidase activity of human polymorphonuclear neutrophils by Brucella melitensis; Orduna A et al.; The degranulation and myeloperoxidase-H2O2-halide activities of human polymorphonuclear leukocytes from healthy donors were tested after co-incubation with either Brucella melitensis 16M, Staphylococcus aureus or Staphylococcus aureus in presence of lipopolysaccharide, protein fraction, native hapten and soluble fractions released at 65 degrees C from smooth strain of Brucella melitensis 16M . The degranulation and myeloperoxidase activities of polymorphonuclear leukocytes were significantly higher when co-incubated with Staphylococcus aureus than with Brucella melitensis . The presence of lipopolysaccharide, protein fraction, and native hapten did not cause significant modification of either degranulation or myeloperoxidase activities of polymorphonuclear leukocytes against Staphylococcus aureus . Soluble fraction released at 65 degrees C produced a significant reduction in the myeloperoxidase activity but did not alter the degranulation of polymorphonuclear leukocytes triggered by Staphylococcus aureus. J Bacteriol, 1991 Sep, 173(18), 5854 - 60 A novel locus conferring fluoroquinolone resistance in Staphylococcus aureus; Trucksis M et al.; Fluoroquinolones such as ciprofloxacin and ofloxacin are potent antimicrobial agents that antagonize the A subunit of DNA gyrase . We selected and mapped a novel fluoroquinolone resistance gene on the Staphylococcus aureus chromosome . Resistant mutants were selected with ciprofloxacin or ofloxacin and were uniformly localized to the A fragment of chromosomal DNA digested with SmaI and arrayed by pulsed-field gel electrophoresis . Several mutants (cfxB, ofxC) were genetically mapped between the thr and trp loci in the A fragment . A majority of A fragment fluoroquinolone resistance mutations were associated with reduced susceptibility to novobiocin, an antagonist of the B subunit of DNA gyrase . Two genes previously associated with fluoroquinolone resistance, the gyrA gene of DNA gyrase and the norA gene (associated with decreased drug accumulation), were localized to the G and D fragments, respectively . Thus, the fluoroquinolone resistance mutations in the A fragment are distinct from previously identified fluoroquinolone resistance mutations in gyrA and norA . Whether mutations in the A fragment after a second topoisomerase or another gene controlling supercoiling or affect drug permeation is unknown. J Immunol, 1991 Aug 15, 147(4), 1299 - 306 Biosynthesis and partial amino acid sequence of the human NDA4 antigen . An activation antigen common to B and T cell lineages; Harris PE et al.; NDA4, a cell surface protein of molecular mass 46 kDa common to activated peripheral blood B and T cells, plays a unique role in the control of B and T cell maturation . NDA4 inhibits B and T cell activation, as mitogen-stimulated B and T cell blastogenic responses are decreased in the presence of mAb NDA4, the antibody recognizing NDA4 . After mitogen-activation, however, the regulatory function of NDA4 changes . Addition of mAb NDA4 to cultures of Staphylococcus aureus Cowan strain A-activated B cells or alloreactive T cell clones stimulates their proliferation . NDA4 epitopes are conserved across primate species lines and are present on transformed cells of neuroectodermal origin . NDA4 is synthesized as a molecular mass 50 kDa precursor and is processed to a mature 46 kDa form within 30 min . The NDA4 Ag also exists as soluble forms of 40 and 42 kDa . The membrane and soluble forms of NDA4 have been purified to homogeneity and sequenced by N-terminal Edman degradation. J Biol Chem, 1991 Aug 15, 266(23), 14903 - 11 The primary structure of coagulation factor IX/factor X-binding protein isolated from the venom of Trimeresurus flavoviridis . Homology with asialoglycoprotein receptors, proteoglycan core protein, tetranectin, and lymphocyte Fc epsilon receptor for immunoglobulin E; Atoda H et al.; An anticoagulant protein, factor IX/factor X-binding protein (IX/X-bp), isolated from the venom of Trimeresurus flavoviridis, binds with factor IX and factor X in the presence of Ca2+ with a 1 to 1 stoichiometry (Atoda, H., and Morita, T . (1989) J . Biochem . (Tokyo) 106, 808-813) . Analysis of S-pyridylethylated IX/X-bp by sodium dodecyl sulfate-polyacrylamide gel electrophoresis revealed a 16.0-kDa band (designated the A chain) and a 15.5-kDa band (designated the B chain) . These two chains were separated by reversed-phase high performance liquid chromatography, and their complete amino acid sequences were determined by sequencing of the peptides obtained after digestion with lysyl endopeptidase, chymotrypsin, and V8 protease from Staphylococcus aureus and after chemical cleavage with cyanogen bromide . The A chain had an amino-terminal sequence of Asp-Cys-Leu-Ser-Gly- and consisted of 129 residues with Mr 14,830 . The B chain has an amino-terminal sequence of Asp-Cys-Pro-Ser-Asp- and consists of 123 residues of Mr 14,440 . There was 47% identity between the A and the B chain . The sequence of IX/X-bp showed 25-37% identity with that of the C-type carbohydrate recognition domain-like structure of acorn barnacle lectin, human and rat asialoglycoprotein receptors, the human lymphocyte Fc epsilon receptor for immunoglobulin E, proteoglycan core protein, pancreatic stone protein, and tetranectin . The sequences of the first 18 amino acid residues of both the A and B chains were also, to a certain extent, homologous to the partial amino acid sequence of the b subunit of factor XIII, a member of the beta 2-glycoprotein I-like family . In this region, some similarity with the amino-terminal amino acid sequence of botrocetin was also observed. FEMS Microbiol Lett, 1991 Aug 15, 66(3), 271 - 7 A recombinant Escherichia coli heat-stable enterotoxin (STa) fusion protein eliciting anti-STa neutralizing antibodies; Lowenadler B et al.; A recombinant fusion protein consisting of native Escherichia coli heat-stable enterotoxin (STa) and a dimer of a synthetic IgG-binding fragment (ZZ), derived from Staphylococcus aureus protein A was produced in E . coli . The fusion protein (ZZSTa) was secreted in large quantities into the growth medium and recovered by affinity chromatography on IgG-Sepharose . Rabbits immunized with the fusion protein responded by producing high serum levels of anti-STa antibodies that also effectively neutralized STa toxicity in infant mice . The fusion peptide ZZSTa had a substantially decreased toxicity as compared with native STa . A polymeric form of ZZSTa separated by size fractionation was about 100 times less toxic than the monomeric fusion protein, yet both forms had the same capacity to induce neutralizing antibodies . This suggests that modified non-toxic forms of ZZSTa with retained immunogenicity may be produced and tested for their usefulness as functional components in a vaccine against diarrhoea caused by enterotoxigenic E . coli. Biochemistry, 1991 Aug 13, 30(32), 8067 - 74 The isolated C-terminal (F2) fragment of the Escherichia coli tryptophan synthase beta 2-subunit folds into a stable, organized nonnative conformation; Chaffotte A et al.; Proteolysis of the beta 2-subunit of Escherichia coli tryptophan synthase by the endoproteinase Glu C from Staphylococcus aureus V8 yields a peptide, F2, corresponding to the C-terminal 101 residues of the beta-chain . The conformation and stability of isolated F2 in phosphate buffer at pH 7.8 (where native beta 2 is stable) have been investigated . Circular dichroism spectra in the far-UV showed the presence of large amounts of secondary structure (19% alpha-helices, 34% extended beta-structures) . Circular dichroism spectra in the near-UV and sedimentation velocity studies indicated an open globular structure with the aromatic side chains in a symmetric (or disordered) environment . NMR spectra and rates of amide proton exchange showed that F2 fluctuates rapidly between several conformations . The thermal denaturation of F2 observed by the loss of far-UV circular dichroism with increasing temperature appeared noncooperative, and indicates a high thermal stability (Tm = 70 degrees C) . Differential scanning microcalorimetry confirmed the absence of cooperativity and indicated a very low value for the calorimetric enthalpy of denaturation (delta H = 17 kJ/mol) . All these properties were compatible with a molten globule . However, the low sedimentation coefficient of F2 suggested a very hydrated and/or expanded structure, and the secondary structure content of isolated F2 (see above) differed widely from that reported in the literature for F2 within the context of native beta 2 (49% alpha-helices and 13% extended beta-structures) . Thus, neither the secondary nor the tertiary structure of isolated F2 resembled those of native F2 . In this respect, isolated F2 is not a "molten globule".(ABSTRACT TRUNCATED AT 250 WORDS) J Dairy Sci, 1991 Aug, 74(8), 2448 - 58 Effects of granulocyte colony-stimulating factor administration to periparturient cows on neutrophils and bacterial shedding; Kehrli ME Jr et al.; Administration of recombinant bovine granulocyte colony stimulatory factor to periparturient dairy cows was evaluated as a method to prevent periparturient immunosuppression . Eleven of 21 cows were experimentally infected with Staphylococcus aureus in one mammary quarter prior to the study . Cows were randomly assigned to four groups in a 2 x 2 factorial design to evaluate the effects of placebo or recombinant bovine granulocyte colony stimulatory factor administration on chronic, subclinically infected and uninfected cows during the periparturient period . Blood neutrophils were isolated and evaluated for phagocytic activities 5 wk before expected parturition through 7 wk postpartum . Administration of recombinant bovine granulocyte colony stimulatory factor (5 micrograms/kg body weight or placebo subcutaneously beginning 14 d prepartum through 10 d post-partum) resulted in a prepartum and postpartum leukocytosis of 35,600/microliters and 53,500/microliters, respectively . This was attributed to a mature neutrophilia of 24,010/microliters during prepartum and 38,080/microliters during postpartum treatment periods (pretreatment baseline = 2330/microliters) . Mononuclear cell counts averaged 7610/microliters during prepartum and 9830/microliters during postpartum treatment periods (baseline = 3450/microliters) . Neutrophil random and directed migration were reduced during recombinant bovine granulocyte colony stimulatory factor treatment compared with placebo or baseline levels . Ingestion of bacteria and cytotoxicity by neutrophils was increased during recombinant bovine granulocyte colony stimulatory factor therapy compared with placebo or baseline levels . Shedding of S . aureus in lacteal secretions was unaffected by recombinant bovine granulocyte colony stimulatory factor treatment . In summary, administration of recombinant bovine granulocyte colony stimulatory factor increased the number and functional activity of neutrophils and prevented some aspects of periparturient immunosuppression in dairy cows. J Biol Chem, 1991 Aug 5, 266(22), 14413 - 7 In vivo effect of asparagine in the hydrophobic region of the signal sequence; Goldstein J et al.; On the basis of the biophysical studies on the synthetic mutant (Ile-8----Asn) OmpA signal peptide in the preceding paper (Hoyt, D . C., and Gierasch, L.M . (1991) J . Biol . Chem . 266, 14406-14412), the in vivo effects of the same mutation were examined by fusing the mutant OmpA signal sequence to Staphylococcus aureus nuclease or TEM beta-lactamase . The mutation in which the isoleucine residue at position 8 of the OmpA signal sequence of Escherichia coli was replaced with a neutral polar residue, asparagine, resulted in a defective signal peptide . The mutant signal sequence was unable to be processed, and the precursor molecule accumulated in the cytoplasmic as well as in the membrane fractions, indicating that the Ile-8----Asn OmpA signal sequence is not competent for translocating nuclease A or beta-lactamase across the membrane . This result is consistent with the in vitro studies on the Ile-8----Asn OmpA signal peptide, which indicated that the mutant signal peptide was unable to penetrate into the hydrophobic core of the lipid bilayer . Other asparagine or glutamine substitution mutations in the hydrophobic region of the OmpA signal sequence were also examined . Interestingly, the OmpA signal sequence with either Ile-8----Gln, Val-10----Asn, or Leu-12----Asn mutation was completely defective as the Ile-8----Asn OmpA signal sequence, while the Ile-6----Asn and Ala-9----Asn OmpA nucleases were able to be processed to secrete nuclease, although the processing occurred at a much slower rate than the wild-type OmpA nuclease . These results indicate that the defects depend on the position of the lesion in the hydrophobic core of the OmpA signal sequence. J Gen Microbiol, 1991 Aug, 137 ( Pt 8), 1999 - 2005 The distribution of homologues of the Escherichia coli KefC K(+)-efflux system in other bacterial species; Douglas RM et al.; Using a variety of techniques the distribution of the glutathione-regulated KefC K(+)-transport system among bacterial species was investigated . The presence of similar systems in a number of Gram-negative bacteria was demonstrated . In contrast, the system appeared to be absent from most Gram-positive bacteria tested with the exception of Staphylococcus aureus . Using the cloned Escherichia coli kefC gene as a probe for Southern hybridization it was shown that only limited DNA sequence homology exists with other bacteria, even when closely related members of the enteric group were examined. Can J Microbiol, 1991 Aug, 37(8), 624 - 31 Deletion mutant analysis of the Staphylococcus aureus plasmid pI258 mercury-resistance determinant; Babich K et al.; Deletion mutant analysis of the mercury-resistant determinant (mer operon) from the Staphylococcus aureus plasmid pI258 was used to verify the location of the merA and merB genes and to show the existence of mercuric ion transport gene(s) . ORF5 was confirmed to be a transport gene and has an amino acid product sequence homologous to the merT gene products from several gram-negative bacteria and a Bacillus species . Deletion analysis established that inactivation of merA on a broad-spectrum mer resistance determinant resulted in a mercury-hypersensitive phenotype . Gene dosage had no apparent effect on the level of resistance conferred by the intact mer operon or on the expression of an inducible phenotype, except that when the intact pI258 mer operon was on a high copy number plasmid, uninduced cells possessed a volatilization rate that was at most only 3.5-fold less than that observed for induced cells . There was no need for mercury ion transport proteins for full resistance when the mer operon was expressed in a high copy number plasmid. Zentralbl Veterinarmed B, 1991 Aug, 38(6), 401 - 10 Induction of anti-phagocytic surface properties of Staphylococcus aureus from bovine mastitis by growth in milk whey; Mamo W et al.; The respiratory burst activity of bovine polymorphonuclear (PMN) cells in response to milk whey- and TSB-grown S . aureus strains isolated from bovine mastitis was studied in whole blood chemiluminescence (CL) and in a CL system with purified bovine neutrophils . In both cases milk whey-grown S . aureus strains elicited significantly less CL than homologous strains grown in TSB . Ingestion of milk whey-grown S . aureus strains by bovine neutrophils was also considerably lower than that of the corresponding homologous organisms grown in TSB . Binding of complement factor C3 to serum-opsonized milk whey-grown S . aureus strains was lower compared with TSB-grown homologous organisms . Moreover, 5 of 6 S . aureus strains grown in milk whey were significantly more resistant to in vivo clearance from the peritoneal cavity of mice compared with homologous bacteria grown in TSB . S . aureus strains grown in TSB exhibited hydrophobic surface properties, whereas homologous strains grown in milk whey were hydrophilic. Nippon Geka Gakkai Zasshi, 1991 Aug, 92(8), 1031 - 4 {Pectoralis major muscle flaps for closure of the infected median sternotomy wound}; Sasaguri S et al.; A case of post-sternotomy mediastinitis due to methicillin-resistant Staphylococcus aureus after aortocoronary bypass procedure was treated with debridement, open clean packing, and delayed wound closure by the technique of pectoral muscle flap mobilization . The cosmetic and functional results were excellent . This technique seems to be a very effective method of treatment for the serious complication of deep sternal infection with mediastinitis after cardiac operation. Childs Nerv Syst, 1991 Aug, 7(4), 211 - 4 Distribution of bacteria in the operating room environment and its relation to ventricular shunt infections: a prospective study; Duhaime AC et al.; In order to study the distribution of bacteria in the operating room environment, cultures were obtained during 111 unselected shunt operations throughout a 10-month period . After routine skin preparation, bacteria were collected by placing Millipore filters on the patient's prepped skin underneath the drapes, on top of the drapes in the operative field, and/or on the sterile instrument table, and left in place for the duration of the case . In 48 patients, full-thickness skin biopsies taken at the initial incision were cultured in lieu of skin surface cultures . Perioperative cerebrospinal fluid cultures and subsequent shunt infections were monitored . Of the 288 environmental (skin and surfaces) cultures, 24 were positive (20 coagulase-negative Staphylococcus and 4 Staphylococcus aureus) . Positive cultures were found in 15 of 111 drape cultures (13.5%), 7 of 77 instrument table cultures (9.1%), and 2 of 97 skin cultures (2.1%) . Positive environmental cultures were not correlated with the surgeon, length of case, time of day, or type of shunt operation, but were more likely to occur in a room other than the designated neurosurgical operating room . There was a correlation between the occurrence of positive environmental cultures and positive cerebrospinal fluid cultures, although the organisms were not always the same . Coagulase-negative Staphylococcus was the most common organism isolated from all sites . We conclude that bacteria most often associated with shunt infections are airborne in the operating room, rather than originating from the patient's skin, and are distributed in the highest concentration near the surgical team.(ABSTRACT TRUNCATED AT 250 WORDS) FEMS Microbiol Immunol, 1991 Aug, 3(4), 193 - 9 Conjugation of capsular polysaccharide to alpha-haemolysin from Staphylococcus aureus as a glycoprotein antigen; Reynaud-Rondier L et al.; The capsular polysaccharides of two pathogenic strains of Staphylococcus aureus 8914 and 31 were isolated and purified . These polysaccharides were conjugated to alpha-haemolysin prepared from the same strains . Amongst the various coupling procedures which were tested the best results were obtained with sodium cyanoborohydride and glutaraldehyde . The conjugates were purified and their immunologic properties were tested . They gave a positive response against antisera from whole bacterial cells. Antimicrob Agents Chemother, 1991 Aug, 35(8), 1612 - 5 Eradication of colonization by methicillin-resistant Staphylococcus aureus by using oral minocycline-rifampin and topical mupirocin; Darouiche R et al.; In an attempt to control the spread of methicillin-resistant Staphylococcus aureus (MRSA) within a spinal cord injury unit, we investigated the mode of transmission and implemented a multidisciplinary approach for control that consisted of grouping of patients into cohorts, contact isolation, and antibiotics . Surveillance cultures of patients and nose and hand cultures of medical personnel were performed . Of 11 colonized patients, 6 had MRSA isolates that shared a similar plasmid profile and antibiogram, raising the possibility of interpatient spread of the organism . Medical personnel had no evident role in transmitting MRSA . All patients' pretherapy MRSA isolates were susceptible to minocycline and, except for one, to rifampin . Time-kill studies showed an indifferent interaction of these two antibiotics . Ten colonized patients received a 2-week oral course of 100 mg of minocycline twice daily and 600 mg of rifampin once daily, while the 11th patient was treated for only 1 week . Patients with colonization of the nares also had twice daily nasal application of 2% mupirocin for 5 days . Colonization with MRSA cleared in 10 of 11 patients (91%) and 20 of 21 sites (95%) . When the individual circumstances of a medical facility justify eradication of MRSA colonization, a multidisciplinary approach that includes antibiotic therapy with oral minocycline and rifampin, along with topical mupirocin for those with nasal carriage, may be successful. Antimicrob Agents Chemother, 1991 Aug, 35(8), 1547 - 50 Development of resistance to fleroxacin during therapy of experimental methicillin-susceptible Staphylococcus aureus endocarditis; Kaatz GW et al.; The efficacy of fleroxacin was compared with that of vancomycin by using the rabbit model of methicillin-susceptible Staphylococcus aureus endocarditis . Animals received intravenous therapy with fleroxacin, 30 mg/kg every 8 h, or vancomycin, 17.5 mg/kg every 6 h, for 4 days . Both antimicrobial agents effectively cleared bacteremia and significantly reduced bacterial counts in vegetations and tissues compared with those in untreated controls . However, resistance to fleroxacin at 5- and 10-fold the MIC arose in the test strain of S . aureus in 73 and 27%, respectively, of animals that received the drug . Resistant isolates were found mainly in vegetations and were composed of up to 7% of the residual population recovered from that site . We conclude that fleroxacin is as effective as vancomycin in this model of a serious systemic S . aureus infection, but resistance to the drug may develop during therapy . If similar results are found with other strains of S . aureus during therapy with this or other fluoroquinolones, such data, when they are combined with the high incidence of fluoroquinolone resistance among S . aureus isolates being reported from selected institutions, would support the contention that these drugs should not be used as first-line therapeutic agents for S . aureus infections. Jpn J Antibiot, 1991 Aug, 44(8), 854 - 9 {A therapy for methicillin-resistant Staphylococcus aureus (MRSA) infections in obstetrics and gynecology}; Chimura T; Although it has been reported that the incidence of methicillin-resistant Staphylococcus aureus (MRSA) infections is extremely low in the obstetrics/gynecology setting, we recently had 5 patients with MRSA infections in the obstetrics/gynecology departments of 4 clinics in Yamagata Prefecture from September 1990 to February 1991 . 1) Classified by disease, 4 of the patients had intrauterine infections (3 puerperal intrauterine infections and 1 intrauterine infection) and 1 had a postoperative wound infection . 2) Classified by treatment after the MRSA isolates had been determined, 2 of the patients were given imipenem/cilastatin alone (which turned out to be effective), 2 were given concomitant IPM/CS + quinolone agents (ofloxacin, tosufloxacin; effective) and 1 was given minocycline and OFLX . The principal lessons we learned from these cases are that attention should be paid to the occurrence of MRSA infection even in the obstetrics/gynecology field and that the method of selecting and administering antibiotics to prevent and treat such infections should be reconsidered. J Am Acad Dermatol, 1991 Aug, 25(2 Pt 1), 257 - 61 The antiinflammatory effects of ketoconazole . A comparative study with hydrocortisone acetate in a model using living and killed Staphylococcus aureus on the skin of guinea-pigs; Van Cutsem J et al.; Several reports have demonstrated the efficacy of topical ketoconazole in dermatologic conditions that are not exclusively related to fungi . Some basic pharmacologic studies have indicated effects of ketoconazole on cholesterol production in keratinocytes, on the 5-lipoxygenase enzyme, and on the metabolism of all-trans-retinoic acid in the skin . These observations have led to the hypothesis that topically applied ketoconazole may possess antiinflammatory properties . This hypothesis was tested in an animal model in which living and killed Staphylococcus aureus applied to the backs of guinea pigs resulted in inflammation with erythema and hyperkeratosis . Ketoconazole 0.5% or 2% was applied topically once daily in an ointment base, either as monotherapy or in combination with hydrocortisone acetate 1% . In addition, untreated, excipient-treated, and hydrocortisone acetate-treated animals were included in the study design . All groups consisted of 10 animals that were observed and scored daily up to 3 days after the experimental therapy was stopped . In the animal model involving killed bacteria (i.e., no infection), topical ketoconazole had antiinflammatory activity comparable to that of hydrocortisone acetate . The activity of ketoconazole on the skin of animals infected with living bacteria (i.e., active bacterial infection) was superior to that of steroid therapy, which suggests some antibacterial effect of topically applied ketoconazole . The combination therapy was highly active under both conditions . These results suggest that, apart from the known antimycotic effects of ketoconazole, this molecule might also have effects against gram-positive bacteria at the high concentrations obtained after local application.(ABSTRACT TRUNCATED AT 250 WORDS) J Antibiot (Tokyo), 1991 Aug, 44(8), 844 - 53 Antibacterial activity of 5-acylaminothiazole derivatives, synthetic drugs related to beta-lactam antibiotics; Pirotte B et al.; Newly synthesized 5-acylaminothiazolium salts and one 5-acylaminothiazolidine, considering their chemical structure and reactivity, have been proposed as potential inhibitors of bacterial serine DD-peptidases . A moderate antibiotic activity with (5-phenylacetylamino-3-thiazolio)acetate and (5-phenylacetylaminothiazolidin-3-yl)acetic acid was observed on Staphylococcus aureus ATCC 25923 . The methyl- and tert-butyl esters of the thiazolium salt have shown lower MIC values . Moreover, when introduced into an exponential growth phase culture of S . aureus, the three active thiazolium salts induced a partial lysis indicating an impairing of the bacterial cell wall biosynthesis . The observed time-dependent binding of the best compound to the PBPs of S . aureus was too slow and occurred at too high concentrations to account for its MIC value . Consequently, the antibiotic activity of the thiazolium salts on the S . aureus cells seems not to be satisfactorily explained by a penicillin-like interaction with the PBPs. Genitourin Med, 1991 Aug, 67(4), 331 - 4 Antibody in sera of patients infected with Trichomonas vaginalis is to trichomonad proteinases; Alderete JF et al.; BACKGROUND--A recent report demonstrated the immunogenic character of the cysteine proteinases of Trichomonas vaginalis . It was of interest, therefore, to examine for the presence of serum anti-proteinase antibody among patients with trichomoniasis . METHODS--An immunoprecipitation assay was used involving protein A-bearing Staphylococcus aureus first coated with the IgG fraction of goat anti-human Ig and then mixed with individual sera of patients to bind human antibody . These antibody-coated bacteria were then added to detergent extracts of T vaginalis . Bound immune complexes on S aureus were washed and solubilised for electrophoretic analysis on acrylamide copolymerised with gelatin for detection of proteinase activity . RESULTS--Sera from patients (50/50), but none from sera of normal, uninfected women, possessed IgG to numerous trichomonad cysteine proteinases . The presence of this serum anti-proteinase antibody disappeared after drug treatment and cure of patients of the T vaginalis infection . CONCLUSIONS--The commonality of the anti-proteinase antibody in the sera of patients with trichomoniasis provided evidence for the expression of the same repertoire of parasite proteinases during infection . These observations have important implications for the in vivo relevance of the proteinases and indicate that strategies to use a specific serum antibody response for diagnosis of this infection may be possible. Int Immunol, 1991 Aug, 3(8), 819 - 26 Clonal analysis of differential lymphokine production in peptide and superantigen induced T cell anergy; O'Hehir RE et al.; A failure of T lymphocytes to produce interleukin 2 (IL-2) on restimulation may, in part, account for the specific unresponsiveness that accompanies incomplete activation . The evidence to support this has been derived predominantly from the investigation of the molecular basis of anergy in murine type 1 T cells . In this study, the effects of different tolerogenic signals delivered by specific peptide or Staphylococcus aureus enterotoxin on the ability of antigen-specific human T cells to produce lymphokines, both in the induction phase and in established antigen-specific non-responsiveness, have been examined . Although T cell proliferation was decreased by supraoptimal concentrations of specific peptide in the presence or absence of antigen presenting cells, IL-2, IL-4, and interferon gamma (IFN-gamma) synthesis were comparable to that of activated T cells . The different tolerogenic signals, all capable of inhibiting phase of unresponsiveness . Restimulation of anergic T cells with an antigenic challenge failed to induce lymphokine production, with the exception of allergen-reactive T cells that secreted IFN-gamma . This latter observation is relevant to the desensitization of specific responsiveness in allergic disease. Surgery, 1991 Aug, 110(2), 277 - 83; discussion 283-4 Oral-TPN-induced bacterial translocation and impaired immune defenses are reversed by refeeding; Mainous M et al.; Although certain defined diets have been shown to promote bacterial translocation (BT), the ability to reverse diet-induced BT has not previously been investigated . Furthermore, little is known about the effects of defined diets on host immune defenses . To address these questions, we measured BT and immune reactivity in rats fed a normal diet or enteral elemental (ORAL-TPN) diet . After 7 days on the elemental or normal diet, the rats were killed, and BT and mitogen responsiveness to concanavalin A and phytohemagglutinin were measured . In separate experiments, the effects of these diets on in vivo host defenses was measured with a Staphylococcus aureus abscess model . Additional experiments were performed to determine the time required to reverse ORAL-TPN-induced BT and impairment of host immune defenses by reinstituting normal feedings . Administration of the ORAL-TPN diet for 7 days was associated with BT to the mesenteric lymph node complex of all animals, decreased blastogenic response of blood and splenic lymphocytes to mitogens, and decreased ability to control an in vivo infectious challenge with S . aureus . Each of the derangements was reversed by the reinstitution of normal feedings . In summary, the enteral administration of an elemental diet for 7 days is associated with disruption of the gut microflora, BT, and the development of an immunocompromised state, all of which can be reversed by refeeding the animals a normal diet. J Clin Pathol, 1991 Aug, 44(8), 681 - 4 Nasal, axillary, and perineal carriage of Staphylococcus aureus among women: identification of strains producing epidermolytic toxin; Dancer SJ et al.; Following two outbreaks of staphylococcal scalded skin syndrome in a maternity unit, 500 pregnant women attending an antenatal clinic were screened for carriage of epidermolytic toxin producing Staphylococcus aureus . Nasal, axillary, and perineal swabs were collected from women whose gestational ages ranged from 12-40 weeks . Isolates of S aureus were purified, phage typed, and tested for methicillin sensitivity and production of epidermolytic toxin . The results showed that 164 (33%) women carried S aureus; of these, 100 (61%) were from the nose and three (2%) from axillae, but 41 (25%) strains were isolated from the perineum alone . Screening for nasal carriage alone will therefore miss 25% of carriers . More than one strain of S aureus was identified in seven of 20 women with multiple site carriage . Three (2%) methicillin resistant strains were isolated during the survey, and five (3%) isolates produced epidermolytic toxin . Phage typing identified 63 (34%) strains as non-typable, but 50% of isolates typed either groups I, II or III, and a further 10% represented varying combinations of these and other phage groups . These results provide baseline information on S aureus in the community, and identification of methicillin resistant and toxin producing strains shows a reservoir of outbreak potential which could become relevant on hospital admission of such a carrier. Acta Orthop Scand, 1991 Aug, 62(4), 315 - 8 Synovectomy for septic arthritis . Early versus late synovectomy studied in the rabbit knee; Riegels-Nielsen P et al.; Thirty rabbits with established unilateral septic arthritis of the knee after inoculation with Staphylococcus aureus received cloxacillin 50 mg/kg x 2 i.m . and probenecid 250 mg x 1 p.o . from Day 3 to 21 . In 26 knees, synovectomy was performed 3, 5, and 7 days after the inoculation, and four knees were not operated on . Further, synovectomy was performed in eight noninfected knees . The rabbits were killed 3 or 7 weeks after the operation, and the specimens were examined macroscopically and microscopically . All the cultures taken postoperatively and at killing were negative . Infected knees synovectomized on Day 3 differed, although marginally, 3 weeks postoperatively from the operated on, uninfected group; a minor loss of cartilage cellularity and glycosaminoglycans was observed, but there were no changes indicating arthrosis . At 7 weeks postoperatively, this difference was more pronounced . If synovectomy was performed at a later stage, increased destruction was observed: after 7 days of infection, all the knees presented cloning and vascular crossing of the tidemark, indicating arthrosis, which did not differ from those knees treated with only antibiotics . We conclude that synovectomy performed early in the course of infection may stop the destructive influence of enzymes and of the synovial membrane leading to irreversible changes in the cartilage. J Med Microbiol, 1991 Aug, 35(2), 80 - 8 Usefulness of three probes in typing isolates of methicillin-resistant Staphylococcus aureus (MRSA); Monzon-Moreno C et al.; Fifty-nine epidemiologically unrelated methicillin-resistant Staphylococcus aureus (MRSA) isolates from different geographical areas and 23 phage-type 77 MRSA isolates from France were investigated . Cellular DNA, digested with restriction endonucleases EcoRI or HindIII, was probed with plasmids carrying the gene encoding 16S rRNA (pBA2), the gene aacA-aphD (pSF815A) and the gene aacA-aphD plus part of IS256 (pIP1307) . When probed with pBA2, most of the unrelated isolates displayed the same hybridisation pattern . A greater diversity in patterns was detected in gentamicin-resistant strains with the two other probes . The most accurate fingerprinting of these isolates was obtained with the probe pIP1307 . Moreover, this probe appeared to be useful for tracing the phage-type 77 epidemic MRSA isolates widespread in French hospitals. J Med Microbiol, 1991 Aug, 35(2), 72 - 9 Transfer of resistance determinants from a multi-resistant Staphylococcus aureus isolate; Udo EE et al.; The clinical isolate Staphylococcus aureus WBG1024 was resistant to cadmium, benzyl penicillin, kanamycin, neomycin, streptomycin, tetracycline and trimethoprim and harboured a conjugative plasmid pWBG637 (34.5 kb) and non-conjugative plasmids of 23.8, 4.4, 2.8 and 1.9 kb . Transduction and mixed-culture transfer experiments demonstrated that the 4.4-kb plasmid (pWBG632) encoded resistance to tetracycline and the 23.8-kb plasmid (pWBG628) encoded resistance to cadmium, benzyl penicillin, kanamycin, neomycin and streptomycin . The conjugative plasmid pWBG637 was able to mobilise a further 4.4-kb plasmid (pWBG633) encoding streptomycin resistance and recombined with the multiresistance plasmid pWBG628 to produce transconjugantes of various resistance phenotypes. J Bone Joint Surg Am, 1991 Aug, 73(7), 1044 - 8 Prophylaxis against infection . Single-dose cefonicid compared with multiple-dose cefamandole; Garcia S et al.; A total of 1489 patients were included in a prospective, randomized study that compared the efficacy of a single dose of cefonicid in 474 patients (Group I) with that of three doses of cefamandole in 510 patients (Group II) and five doses of cefamandole in 505 patients (Group III), for prophylaxis against infection after an operation on bone . The operations involved the insertion of a Moore prosthesis, an Ender and Kuntscher nail, a bone-plate, or another device for internal fixation . Patients who had an open fracture or a total joint replacement were not included in the study . The three groups were similar with regard to mean age, sex ratio, duration of preoperative hospitalization, underlying risk factors, and type of operation . The rates of wound infection were not significantly different in the three groups (p = 0.8) or when the rates were stratified according to the type of operation (p greater than 0.3) . Staphylococcus aureus and gram-negative bacilli were the most common infecting microorganisms . The rate of mortality related to infection was similar in all three groups (p = 0.2) . No adverse side-effects of drugs were encountered . A single preoperative dose of cefonicid, three doses of cefamandole, and five doses of cefamandole were equally effective prophylaxis against infection of the wound in these patients. Am J Med, 1991 Aug, 91(2), 129 - 36 Pyomyositis in patients with the human immunodeficiency virus: an unusual form of disseminated bacterial infection; Widrow CA et al.; PURPOSE AND PATIENTS: Pyomyositis, a common disease in the tropics, is rare in the continental United States, with approximately 83 cases described in the literature in the past two decades . The occurrence of pyomyositis complicating human immunodeficiency virus (HIV) infection has been reported in 10 patients since 1986 . We report six cases of this entity in patients with advanced HIV disease seen in our institution over a 20-month period . A common denominator in all of our patients was muscle injury, induced by either exercise or trauma . Unlike most previous reports of HIV-associated pyomyositis, the clinical picture in our cases was complicated by the development of abscesses in multiple muscle groups, requiring prolonged antimicrobial therapy and repeated drainage procedures for successful management . Interestingly, one patient developed concomitant rhabdomyolysis--an otherwise rare event in classical pyomyositis . Staphylococcus aureus was the predominant infecting organism in this as well as all other series . Of note, we also observed and report the first case, to our knowledge, of gram-negative pyomyositis in an HIV-infected individual . The pathogenic implications of this catalase-producing gram-negative isolate are discussed in the context of neutrophil abnormalities in HIV disease . CONCLUSION: Like tropical pyomyositis, its HIV-associated counterpart appears to be multifactorial in origin . Its recent recognition suggests that, in addition to underlying abnormalities of host defense, factors relating to the prolonged survival of patients with late-stage disease, including myopathy, might play an important contributory role. Am J Kidney Dis, 1991 Aug, 18(2), 225 - 31 Randomized controlled trial of prophylactic rifampin for peritoneal dialysis-related infections; Zimmerman SW et al.; Staphylococcal infections are a major cause of catheter infections and peritonitis in peritoneal dialysis patients . Since catheter-related infections are associated with nasal carriage of Staphylococcus aureus in this population, we studied the effect of intermittent rifampin, an antibiotic known to decrease S aureus nasal carriage, on catheter-related infections and peritonitis . We randomly assigned 64 patients to receive either rifampin 300 mg twice daily for 5 days every 3 months or no treatment . The rifampin-treated patients had a significant delay in time to first catheter-related infection (P less than 0.015) and significantly fewer catheter-related infections overall (P less than 0.001) . The catheter-related infection rate in rifampin-treated patients was .26 per patient-year versus .93 per patient-year in untreated patients . Multivariate analysis defined baseline colonization of nares or catheter exit-site and prior renal transplant as risk factors for catheter-related infections . There was no significant difference in peritonitis rates between groups, although the trend was for a delayed time to first episodes and fewer episodes in rifampin-treated patients . Adverse effects necessitated withdrawal of rifampin in four patients . We conclude that intermittent rifampin administration is effective in decreasing catheter-related infections in a peritoneal dialysis population. Chest, 1991 Aug, 100(2), 439 - 44 Incidence, etiology, and outcome of nosocomial pneumonia in mechanically ventilated patients; Rello J et al.; This study assessed the incidence, etiology, and consequences of ventilator-associated pneumonia in 1,000 consecutive patients admitted in a medical-surgical intensive care unit (ICU) . A total of 264 patients were submitted to mechanical ventilation (MV) for more than 48 hours . Fifty-eight (21.9 percent) patients developed a bacterial pneumonia after a mean of 7.9 days (range, 2 to 40 days) of MV . In addition, they were ten superinfections in nine patients, raising the mean incidence to 25.7 percent . Five patients developed secondary bacteremia, and another five had septic shock . Identification of the causative agent of pneumonia was possible in 47 episodes by means of highly specific techniques (telescoping plugged catheter, blood cultures, and/or necropsy) . Thirteen (27.6 percent) of these cases were polymicrobial . The predomin