Scand J Gastroenterol Suppl, 1988, 143, 77 - 80 Strategies of Pseudomonas aeruginosa to colonize and to persist in the cystic fibrosis lung; Kubesch P et al.; The early stage of the colonization of Pseudomonas aeruginosa in cystic fibrosis (CF) was investigated . Most CF patients, once they have become colonized, harboured genomically related P . aeruginosa strains in their respiratory tract over long periods . Unrelated CF patients were colonized with different strains; however, within families cross-infection between CF siblings frequently took place . Adherence tests with buccal epithelial cells demonstrated that the epithelial cell layer of the oropharynx remained intact for up to 2 years after the onset of colonization with P . aeruginosa . Among the constituents of the microcolony the bronchial mucins were determined to be the major binding targets of CF isolates of P . aeruginosa . The time course of antibody formation to outer membrane antigens of P . aeruginosa in CF serum was analysed by Western immunoblots . Lipopolysaccharide and protein H induced the first systemic immune response. Scand J Gastroenterol Suppl, 1988, 143, 68 - 9 Iron-chelating substances and inflammation; Doring G et al.; The effect of Pseudomonas aeruginosa alkaline protease (AP), elastase (Ela), and the elastase from polymorphonuclear leukocytes (PMN Ela) on iron acquisition of pyoverdin from human transferrin and lactoferrin at physiologic pH was investigated . Incubation of iron-loaded transferrin with iron-free pyoverdin for 10 h at 40 degrees C in the presence of Ela yielded pyoverdin-iron(III) complex, in contrast to incubations of transferrin with pyoverdin alone, AP, or PMN Ela . Sodium dodecyl sulfate polyacrylamide gel electrophoresis analysis of the incubations revealed fragmentation of transferrin by Ela in peptides smaller than 14,000 daltons, whereas AP and PMN Ela cleaved transferrin in fragments of 49,000 d and 43,000 d, respectively . Incubations of lactoferrin with the proteases and pyoverdin or pyoverdin alone did not result in iron acquisition by pyoverdin; however, lactoferrin was fragmented by Ela and AP. Can J Microbiol, 1988 Jan, 34(1), 12 - 8 Amikacin disrupts the cell envelope of Pseudomonas aeruginosa ATCC 9027; Walker SG et al.; Amikacin, an aminoglycoside known to inhibit protein synthesis, was found to perturb the outer membrane of a sensitive Pseudomonas aeruginosa strain (ATCC 9027) . This perturbation was monitored using electron microscopy and biochemical analyses . Following exposure to 20 micrograms amikacin/mL for 15 min, the outer membrane of exponentially growing cells lost 15% of its protein, 18% of its lipopolysaccharide, and 18% of its phosphate . Sodium dodecyl sulphate-polyacrylamide gel electrophoresis showed that the whole spectrum of outer membrane protein and lipopolysaccharide was affected . Similarly, atomic absorption spectrophotometry revealed that magnesium and calcium were also lost . When cells were treated with amikacin, electron microscopy of negative stains showed a substantial increase in outer membrane blebbing . Freeze fractures revealed changes in membrane fracture pattern and particle distribution, and thin sections revealed a sequential disruption of the cell envelope beginning at the outer membrane and ending at the plasma membrane . This study supports the proposal that aminoglycoside antibiotics cross the outer membrane of Pseudomonas aeruginosa by displacing metal cations necessary to stabilize the organic constituents of the membrane . Their removal results in loss of the outer membrane and the formation of transient small holes which permit the antibiotic access to the cytoplasmic membrane where it is transported into the cytoplasm. Zentralbl Bakteriol Mikrobiol Hyg {B}, 1988 Jan, 185(4-5), 520 - 5 {Pseudomonas aeruginosa contamination of disinfectant solutions from central disinfectant dispensing devices in swimming pools}; Schoenen D et al.; The disinfectant solutions from central dosing operators in swimming-bathes were microbiologically tested . The disinfectant solutions in all but one of the tested swimming-bathes showed a microbial colonization . The number of colonies ranged to 3 X 10(5) Col/ml and in 11 of the 24 tested bathes Pseudomonas aeruginosa could be isolated from the disinfectant solutions . Especially the occurrence of P . aeruginosa is quite unfavourable . Due to the results special restorations seem to be necessary. Zh Mikrobiol Epidemiol Immunobiol, 1988 Jan, (1), 3 - 8 {Physico-chemical and biological characteristics of Pseudomonas aeruginosa elastase}; El-Bazza ZE et al.; Elastase isolated from P . aeruginosa clinical strain hydrolyzes elastin, casein, hemoglobin, ovalbumin, gelatin, fibrin, collagen . The optimum pH ensuring the activity of the enzyme is 7.8-8.0 . Elastase shows maximum stability at pH 6.6-9.0 . Heating at 80 degrees C for 10 minutes results in its practically complete inactivation . Elastase is a highly radiosensitive enzyme . Chelating agents and zinc, cobalt, mercury ions suppress its activity . Sodium and ammonium chlorides selectively inhibit the elastolytic, but not proteolytic activity of the enzyme . Elastase shows pronounced dermonecrotic and keratolytic action. Infection, 1988, 16(1), 58 - 62 The relative efficacies of tobramycin and ciprofloxacin against Pseudomonas aeruginosa in vitro and in normal and granulocytopenic mice; Hoogeterp JJ et al.; Ciprofloxacin was studied in vitro and in an experimental thigh infection model in mice to evaluate its efficacy against Pseudomonas aeruginosa in comparison with that of tobramycin . The in vivo experiments were carried out in normal mice as well as mice rendered granulocytopenic by irradiation . The MIC of ciprofloxacin for two Pseudomonas strains was 0.125 mg/l and 0.25 mg/l and that of tobramycin 0.25 mg/l and 4.0 mg/l, respectively . In vitro short-term growth experiments revealed that as far as initial killing rate is concerned, ciprofloxacin was 2.20 times as potent as tobramycin against the first strain and 45.4 times as potent against the second strain . The in vivo experiments were performed by injecting the micro-organism into the thigh muscle and counting colony forming units (CFUs) after several hours of exposure to the antibiotics . The results for irradiated mice indicate that ciprofloxacin was 2.0 times as potent as tobramycin against the first strain and 37.8 times as potent against the second strain, when related to dosage . For normal mice these values were 2.0 and 16.0, respectively, which is more than would be expected from the in vitro experiments because the mean plasma concentrations of tobramycin were about four times higher than those of ciprofloxacin. Mol Gen Mikrobiol Virusol, 1988 Jan, (1), 25 - 9 {Localization of prophage SM of Pseudomonas aeruginosa in the chromosome of host cells}; Gorelyshev AS et al.; Pseudomonas aeruginosa PAO SM-prophage was localized on the chromosome between thr-9001 and pur-66 locuses on 42-43 min of chromosomal genetic map . The location of prophage was identified on the basis of prophage linkage with the above-mentioned markers and confirmed by the purine, hypoxanthine and threonine deletions in course of thermoinduction of SM cts6 prophage from lysogens . The decrease for two orders in lysogenization frequency of thr mutants by SM bacteriophage suggests the integration of SM prophage in these cells into some other region of chromosome. J Antimicrob Chemother, 1988 Jan, 21(1), 49 - 55 Bactericidal activity and killing rate of serum in volunteers receiving pefloxacin alone or in combination with ceftazidime, piperacillin or mezlocillin against Pseudomonas aeruginosa; Van der Auwera P et al.; The activity of the combination of pefloxacin with ceftazidime, piperacillin, or mezlocillin was compared to the activity of the same antibiotics given alone, by measurement of serum bactericidal titres and the rate of killing of ten strains of Pseudomonas aeruginosa . Three groups of five volunteers each received pefloxacin (12 mg/kg iv) with or without ceftazidime, piperacillin or mezlocillin (25 mg/kg iv) . Serum samples were obtained at the end of the infusion . The mean serum concentration of pefloxacin at this time was 13.9 mg/l (3.2, S.D.) . The activity of each of the three combinations was identical to the corresponding activity of the beta-lactam alone . However, the emergence of resistance to pefloxacin was prevented by ceftazidime (five out of five strains), and piperacillin (two out of five strains) . We conclude that combinations of pefloxacin with beta-lactam antibiotics may not increase efficacy against P . aeruginosa. Cytobios, 1988, 53(212), 19 - 29 The use of saline W, a physiological salt solution for experimentation on insect immunity; Jarosz J; In a series of induction experiments using various Ringer solutions attempts were made to determine whether saline W, a physiological salt solution for Lepidoptera, when injected into the larval haemocoel of the greater wax moth could be recognized by the insect as a non-self molecule . Laboratory bioassays indicated the loss of insect body integrity following intracoelomic injection of saline W and three other salines, increased levels of haemolymph lysozyme activity (EC 3 . 2 . 1 . 17), and elevated resistance to the bacterial parasite, Pseudomonas aeruginosa . The inducing effect of saline W was stronger than dipterous Ringer's solution or other physiological salines . The stimulating effects indicate that the moth distinguishes between self and non-self, and this provides a new insight into the induction of the immune response. Eur J Cancer Clin Oncol, 1988, 24 Suppl 1, S47 - 54 Bacterial and host factors affecting Pseudomonas aeruginosa colonization versus bacteremia in granulocytopenic patients; Dick JD et al.; In order to evaluate bacterial factors which might predispose to P . aeruginosa colonization or bacteremia in the granulocytopenic patient, 132 isolates recovered from 44 oncology patients were evaluated for antigenic serotype, iron correctable sensitivity to pooled human serum, antibiotic susceptibility, production of lecithinase, elastase, protease, gelatinase, pyocyanin and pyoverdin . Similarly, potential host factors, primarily total iron binding capacity, were evaluated in a subpopulation of acute leukemia patients composed of 13 control patients without P . aeruginosa cultured during their hospital course, 11 colonization only patients and 15 P . aeruginosa bacteremia patients . No significant differences were observed between strains recovered from bacteremia vs . colonization patients for extracellular enzyme activity, pigment production, serum sensitivity and antigenic serotype . Significant differences were observed between bacteremia and colonizing strains for antibiotic susceptibility to ticarcillin, 40% vs . 76% (P less than 0.002); piperacillin, 44% vs . 86% (P less than 0.006); and cefsulodin, 60% vs . 90% (P less than 0.02) . Of the host factors evaluated in the acute leukemia patients, significant differences were observed between the TIBC nadir of control patients and both colonization patients (P less than 0.0002) and bacteremia patients (P less than 0.0004) . P . aeruginosa bacteremia was associated with the temporal occurrence of TIBC nadir and the detection of the organism . These data suggest a possible role for beta-lactam antibiotic resistance and host iron binding capacity as determinants and possible predictors of P . aeruginosa sepsis in the granulocytopenic patient. Arch Biochem Biophys, 1988 Jan, 260(1), 493 - 6 Pseudomonas aeruginosa and Pseudomonas cepacia isolated from cystic fibrosis patients bind specifically to gangliotetraosylceramide (asialo GM1) and gangliotriaosylceramide (asialo GM2); Krivan HC et al.; Pseudomonas aeruginosa infection in the lungs is a leading cause of death of patients with cystic fibrosis, yet a specific receptor that mediates adhesion of the bacteria to host tissue has not been identified . To examine the possible role of carbohydrates for bacterial adhesion, two species of Pseudomonas isolated from patients with cystic fibrosis were studied for binding to glycolipids . P . aeruginosa and P . cepacia labeled with 125I were layered on thin-layer chromatograms of separated glycolipids and bound bacteria were detected by autoradiography . Both isolates bound specifically to asialo GM1 (Gal beta 1-3GalNAc beta 1-4Gal beta 1-4Glc beta 1-1Cer) and asialo GM2 (GalNAc beta 1-4Gal beta 1-4Glc beta 1-1Cer) but not to lactosylceramide (Gal beta 1-4Glc beta 1-1Cer), globoside (GalNAc beta 1-3Gal alpha 1-4Gal beta 1-4Glc beta 1-1Cer), paragloboside (Gal beta 1-4GlcNAc beta 1-3Gal beta 1-4Glc beta 1-1Cer), or several other glycolipids that were tested . Asialo GM1 and asialo GM2 bound the bacteria equally well, exhibiting similar binding curves in solid-phase binding assays with a detection limit of 200 ng of either glycolipid . Both isolates also did not bind to GM1, GM2, or GDla suggesting that substitution of the glycolipids with sialosyl residues prevents binding . As the Pseudomonas do not bind to lactosylceramide, the beta-N-acetylgalactosamine residue, positioned internally in asialo GM1 and terminally in asialo GM2, is probably required for binding . beta-N-Acetylgalactosamine itself, however, is not sufficient as the bacteria do not bind to globoside or to the Forssman glycolipid . These data suggest that P . aeruginosa and P . cepacia recognize at least terminal or internal GalNAc beta 1-4Gal sequences in glycolipids which may be receptors for these pathogenic bacteria. J Craniomaxillofac Surg, 1988 Jan, 16(1), 28 - 30 Necrotizing destruction of the ocular adnexa by Pseudomonas aeruginosa; Steinkogler FJ et al.; In a six weeks old boy, a necrotizing Pseudomonas infection had destroyed nearly the whole lid apparatus, the lacrimal structures of the right eye and the medial canthal region, the medial thirds of the eyelids and the lacrimal passages on the left side . The infection was only controlled by intensive antibiotic therapy after more than two weeks . The exposure keratitis of the right eye was followed by corneal perforation, two months after the beginning of the therapy . A keratoplasty was performed, but soon a staphyloma and later, dense scarring developed . After the haematological and immunological situation was under control we could contemplate covering the large defect in the medial canthal area (open right canalis nasolacrimalis) at the age of seven months . The right lower lid has to be reconstructed later . The left eyelid defects have closed by spontaneous granulation . The little boy is no longer receiving antibiotic treatment and is developing very well. J Bacteriol, 1988 Jan, 170(1), 393 - 9 Catabolism of aromatic biogenic amines by Pseudomonas aeruginosa PAO1 via meta cleavage of homoprotocatechuic acid; Cuskey SM et al.; Pseudomonas aeruginosa PAO1 catabolized the aromatic amines tyramine and octopamine through 4-hydroxyphenylacetic acid and 3,4-dihydroxyphenylacetic acid (HPA) . meta ring cleavage was mediated by 3,4-dihydroxyphenylacetate 2,3-dioxygenase (HPADO), producing 2-hydroxy-5-carboxymethylmuconic semialdehyde (MSA) . An NAD-dependent dehydrogenase caused the disappearance of the yellow MSA product, probably forming 2-hydroxy-5-carboxymethylmuconic acid . Induction studies with extracts from mutant cells indicated that the inducer of HPADO was HPA and/or MSA . Strains PAO1.221 (tynC1) and PAO1.303 (tynD1) have chromosomal mutations causing a deficiency in the activity necessary for conversion of 4-hydroxyphenylacetic acid to HPA . Genetic analyses showed that the mutations were in different loci . Strains PAO1.197 (tynE1) and PAO1.185 (tynF1) are deficient in HPADO and the NAD-dependent dehydrogenase, respectively . Plasmid pRO1853 was constructed by cloning approximately 7.3 kilobases of PAO1 chromosomal DNA into the BamHI site of the vector plasmid pRO1614 . This recombinant plasmid complemented the tynD1, tynE1, and tynF1 mutations . A putative repressor-binding site involved in the regulation of HPADO synthesis was observed for a subcloned fragment of pRO1853 . This recombinant plasmid, pRO1863, failed to complement tynE1 or tynF1 but still complemented tynD1 . Another construct, pRO1887, contained 9.2 kilobases of PAO1 chromosomal DNA inserted in the PstI site of the vector pRO1727 . Plasmid pRO1887 complemented only the tynC1 mutation . Mapping experiments performed with the chromosome-mobilizing plasmid R68.45 located the mutations described above in a cluster at about 35 to 40 min of the PAO1 chromosome map . The mutations were linked to the proA, thr-48, lys-9015, argF10, and argG markers. Infect Immun, 1988 Jan, 56(1), 291 - 3 Impact of proteases on iron uptake of Pseudomonas aeruginosa pyoverdin from transferrin and lactoferrin; Doring G et al.; The Pseudomonas aeruginosa siderophore pyoverdin was unable to acquire iron from human transferrin or lactoferrin at physiological pH . However, in the presence of P . aeruginosa elastase, rapid iron release and pyoverdin iron uptake from transferrin but not from lactoferrin were detected . Neither P . aeruginosa alkaline protease nor elastase from polymorphonuclear leukocytes revealed this effect. Infect Immun, 1988 Jan, 56(1), 213 - 8 Induction of murine cytolytic T lymphocytes by Pseudomonas aeruginosa exotoxin A; Zehavi-Willner T; Pseudomonas aeruginosa exotoxin A (PA), a potent protein synthesis inhibitor, was found to be a weak T-cell mitogen for murine splenocytes . Maximal stimulation of {3H}thymidine incorporation was obtained with 10 to 100 ng of toxin per ml following a 4-day induction . PA was also shown to be a polyclonal activator of cytolytic T lymphocytes (CTL), effective against concanavalin A-treated target cells . The effective PA dose for CTL induction was the same as that for mitogenic stimulation, only with a prolonged priming time (7 days) . In contrast to other mitogens, PA could not reactivate memory CTL into secondary CTL . The stimulation of CTL by subcytotoxic doses of PA may be relevant to its modulatory effect on the immunocellular system. Biotherapy, 1988, 1(1), 19 - 25 The effects of recombinant interleukin-1 and recombinant tumor necrosis factor on non-specific resistance to infection; van der Meer JW; Natural and synthetic immunomodulators that increase non-specific resistance to infection induce the production of interleukin-1 (IL-1) and tumor necrosis factor (TNF) . Therefore, we investigated the effect of IL-1 and of TNF on the survival of lethally-infected mice . Mice were injected with 1 x 10(6) Klebsiella pneumoniae in the thigh muscle . When recombinant human IL-1 beta was given as a single i.p . injection 24 h before the infection, survival was increased . Using 80 ng IL-1 beta per mouse, survival compared to control animals was 80% versus 20% 48 h after the infection (p less than 0.001) . No effect of IL-1 was observed when it was given 1/2 h before or 6 h after the infection . IL-1 alpha proved to be at least as potent as IL-1 beta . Numbers of bacteria cultured from the blood, thigh muscle, liver, spleen, and kidney were similar in IL-1-treated and control animals . Protection against death by IL-1 was also investigated in granulocytopenic mice with a Pseudomonas aeruginosa infection . Administration of the cyclooxygenase-inhibitor, ibuprofen, did not affect the beneficial effect of IL-1 . In this model human recombinant TNF was at least tenfold less active than IL-1 beta . Pretreatment with IL-1 also had a significant effect on survival of mice that received a high dose of bacterial lipopolysaccharide. G Batteriol Virol Immunol, 1988 Jan-Dec, 81(1-12), 47 - 53 {The use of ofloxacin in otorhinolaryngology}; Cavallo GP et al.; Continuing development of antimicrobial resistance highlights the need for new antimicrobial agents . Despite many new molecules there is still a need for effective oral compounds . The fluoroquinolones are a new group of antibiotics with a wide spectrum of antibacterial activity which includes resistant strains and difficult microorganisms as Pseudomonas aeruginosa . Ofloxacin is a fluoroquinolone available for oral use showing good absorption with high blood levels and quite satisfactory tissue, penetration particularly in O.R.L . district . The treatment, consisting of ofloxacin 200 mg twice daily, of several patient (including two cases of rhinitis) was both safe and effective. Jpn J Ophthalmol, 1988, 32(3), 264 - 7 Microbial contamination of donor eyes; Panda A et al.; A total number of 1,516 donor eyes received from various sources during the years 1973-1985 were subjected to the isolation of bacterial contamination . The bacterial cultures taken from the pretreatment eyeball showed culture growth in 366 (24.1%) eyes . Of the 366 positive cultures, 331 (21.8%) were bacterial and 35 (2.3%) were fungal . Amongst the bacterial the major contamination was by staphylococcus aureus and albus and pseudomonas aeruginosa . Gentamicin was found to be the most sensitive antibiotic against a wider group of organisms, the next being chloramphenicol . Thus, treatment of a cadaver eye with a solution of normal saline containing 0.1-0.5 mg/ml of gentamicin is recommended before and after the donor eye is enucleated. Drugs Exp Clin Res, 1988, 14(6), 397 - 402 Mode of action of BO-1341: transport pathway through the outer membrane of Escherichia coli; Sanada M et al.; BO-1341, a new semisynthetic cephalosporin having a 6,7-dihydroxyisoquinolinium moiety at the C-3 methylene, possesses potent antibacterial activity against Gram-negative bacteria including glucose-nonfermentative bacteria, especially Pseudomonas aeruginosa . In order to elucidate the mechanisms of action, the transport pathway of BO-1341 through the outer membrane of Escherichia coli was studied . The antibacterial activity of BO-1341 was not affected by the deficiency in OmpF and OmpC porin channels compared with its wild-type strain, but was affected by the iron concentration in the medium . Susceptibility testing with the mutants involved in the iron transport system indicated that the tonB mutant was resistant to BO-1341 . Analysis of the spontaneous mutants resistant to BO-1341 revealed a mutation in the tonB gene . The strong activity of BO-1341 and the lack of cross-resistance to other cephalosporins may be attributable to the unique transport system through the outer membrane of Gram-negative bacteria. Pediatrie, 1988, 43(5), 397 - 404 {The new penicillins}; Borderon JC; During recent years, new antibacterial beta-lactams have been identified . The association of beta-lactams and beta-lactamase inhibitors (clavulanic acid or sulbactam) represent a new therapeutic approach . The other drugs are classified into ureodopenicillins (mezlocillin, azlocillin, piperacillin), amidinopenicillins (mecillinam, pivmecillinam), monobactam (aztreonam) and penems (imipenem) . Three mechanisms are involved in the bacterial resistance to these beta-lactams: inability to cross the bacterial membrane, inactivation of the antibiotic by a beta-lactamase, modification of the number of porines . The tolerance to these new products is good but they present a high risk for selection of resistant bacteria . These antibiotics markedly improve the treatment of beta-lactamase producing bacterial infections, particularly related to Pseudomonas aeruginosa. Int Arch Allergy Appl Immunol, 1988, 85(2), 208 - 12 Decreased T helper cell function in patients with cystic fibrosis; Knutsen AP et al.; T cell immune function was further evaluated in cystic fibrosis (CF) patients . CF patients, regardless of severity of pulmonary disease or colonization with Pseudomonas aeruginosa, had lower percentages of T helper cells (p less than 0.01) and decreased T helper function as demonstrated by diminished T help for control B cell pokeweed mitogen-stimulated IgG (p less than 0.01) and IgM (p less than 0.01) synthesis . Increased T suppressor function, measured by co-culture with control B and T cells, was noted in only 25% of CF patients . CF patients' T cells exhibited decreased allogeneic T cell cytotoxicity compared to normal controls (p less than 0.01) . This study extends previous studies demonstrating decreased T cell functions in CF patients and indicates a specific decrease in T helper function. Microbiol Immunol, 1988, 32(2), 131 - 9 Role of pili in the pathogenesis of Pseudomonas aeruginosa burn infection; Sato H et al.; The present study using three isogenic mutants (F+P-, F-P+, F-P-) of Pseudomonas aeruginosa indicates that the presence of pili enhances the virulence of the organisms in experimental P . aeruginosa burn infection of mice . The 50% lethal dose (LD50) value for burned mice inoculated with non-piliated (P-) mutant was at least ten times higher than those inoculated with piliated (P+) bacteria . Meanwhile the LD50 value for burned mice inoculated with non-flagellated (F-) mutant was at least 10(5) times higher than those inoculated with flagellated (F+) bacteria . At 24 hr after inoculation, the bacterial counts in burned skin of mice inoculated with P+ bacteria were ten times higher than those inoculated with P- bacteria; and at 48 hr the bacterial counts became a hundred times higher in the former mice than the latter . At 24 hr after inoculation, P+ bacteria were isolated from blood, liver (F+P+), lung (F+P+), and kidney, while P- bacteria were not present in these tissues . And at 48 hr after inoculation, P+ bacteria were isolated from all tissues, while P- bacteria were isolated from some sites only . These results suggested that pili and flagella each play an important role as virulence factors independently, and that pili-mediated enhancement of virulence of P . aeruginosa was attributed to pili-mediated enhanced colonization of the organisms at the burned skin surfaces. J Hosp Infect, 1988 Jan, 11(1), 68 - 76 Antimicrobial properties of antiseptic-impregnated biological dressings; Kearney JN et al.; Three antiseptics--chlorhexidine acetate, silver nitrate and povidone-iodine--were incorporated into biological dressings (human skin and amnio-chorion) and evaluated in vitro against disparate micro-organisms . Results indicated that antimicrobial levels of chlorhexidine and silver were released from the dressings over a clinically relevant time period, whereas povidone-iodine was ineffective . Chlorhexidine dressings demonstrated broad-spectrum activity, whereas silver dressings were most effective against Pseudomonas aeruginosa. J Hosp Infect, 1988 Jan, 11(1), 60 - 7 Comparison of sodium hypochlorite and sodium dichloroisocyanurate disinfectants: neutralization by serum; Coates D; A comparison has been made of the activity against Pseudomonas aeruginosa of sodium hypochlorite (NaOCl) and sodium dichloroisocyanurate (NaDCC) solutions containing 0-40% and 0-70% horse serum respectively . The degree of inactivation of NaOCl and of NaDCC solutions by different concentrations of horse serum is expressed in terms of a neutralization coefficient, which demonstrates that NaDCC solutions are less prone to inactivation by serum than are NaOCl solutions, the disparity diverging as serum concentration is increased . In 30% serum an NaDCC solution containing 4000 ppm of available chlorine exhibited similar bactericidal activity to an NaOCl solution containing 17,000 ppm available chlorine. Ann Otolaryngol Chir Cervicofac, 1988, 105(5), 349 - 53 {Short-term complications of transtympanic aerators}; Francois M et al.; Three hundred and thirteen transtympanic aerators (TTA), including 309 T-tubes, were inserted between november 1985 and April 1987 at the Bretonneau hospital, Paris . Twenty-three (7%) were expelled spontaneously, 16 (5%) became obstructive and in 6 cases a change of TTA was required . The commonest complication was otorrhea . Younger children tended to develop early otorrhea . There were 7 cases (2%) of early otorrhea and 50 (16%) of secondary otorrhea . By contrast the onset of secondary otorrhea was independent of age . A relationship with penetration of water into the middle ear through the TTA could not be confirmed . At the present time the authors permit bathing without any special precautions . In parallel, between november 1985 and august 1987, 84 bacteriological samples were obtained in cases of otorrhea related with a TTA, whether or not the latter had been inserted at Bretonneau . Predominant organisms were Hemophilus influenzae (30%), Pseudomonas aeruginosa (30%) and Staphylococcus (18%) . On the basis of results of antibiotic sensitivity studies using the organisms discovered in these samples, the authors suggest local therapy based upon polymyxin or rifamycin as treatment of first choice. Scand J Infect Dis, 1988, 20(2), 199 - 203 Aminoglycoside resistance patterns in Turkey; Akalin HE et al.; Resistance of gram-negative aerobic bacteria to aminoglycoside antibiotics differs by region and country . It is known that 54% of gram-negative bacilli in Turkey are resistant to gentamicin, 32% to netilmicin, 35% to tobramycin, and only 0.9% to amikacin . Resistance to these antibiotics is generally caused by aminoglycoside-modifying enzymes . The resistance mechanisms of 300 aminoglycoside-resistant gram-negative bacteria were evaluated by determination of susceptibility to selected aminoglycosides . Comparison of strains isolated from community acquired infections and hospital acquired infections was made . Of the strains from community, 45.4% had an aminoglycoside resistance pattern indicative of 2''-adenyltransferase {ANT(2'')} . This was found in 44.4% of the hospital isolates . In both groups the second common enzyme was the 3-acetyltransferase {AAC(3)-II}, in 20.8% and 23.3% respectively . Overall, most strains had an aminoglycoside resistance pattern indicative of ANT(2''), followed by AAC(3)-II and AAC(3)-I . Among bacteria tested, AAC(3)-II was the most common enzyme in Pseudomonas aeruginosa . The results of this study suggest that local antibiotic prescribing patterns play an important role in regional resistance mechanisms. Microbiologica, 1988 Jan, 11(1), 47 - 53 Beta-lactam resistant Pseudomonas aeruginosa strains emerging during therapy: synergistic resistance mechanisms; Pagani L et al.; The emergence of beta-lactam resistant strains of Pseudomonas aeruginosa during treatment was studied . Three different strains present before treatment persisted with changes in their beta-lactam resistance during treatment . The isolates before and after therapy were studied for beta-lactamase production and permeability barrier . The increased beta-lactam resistance was correlated with an increased permeability barrier . In order to verify if the permeability barrier was correlated with changes in outer membrane proteins, outer membrane preparations were analyzed by SDS-PAGE . Several differences were observed between the OMP profiles of the post therapy and the pre therapy isolates . Furthermore, an analysis of PBPs pattern of strains studied was carried out and alterations in target proteins were observed. Acta Microbiol Pol, 1988, 37(3-4), 295 - 307 The estimation of usefulness of Pseudomonas bacteriophages in epidemiological investigations of Pseudomonas aeruginosa clinical strains; Dabrowski M et al.; Out of 20 Pseudomonas phages, 17 were most suitable for typing of Pseudomonas aeruginosa strains isolated from different sources of human infections . These phages have been classified into three taxons based on coefficient of correlation of their lytic activity . Out of these strains only one appeared nontypeable . 240 distinquished phagotypes were classified into three groups and seven subgroups . This schema of classification was used in the epidemiological investigations of the Pseudomonas strains in relation to the category of infection and the place of isolation . Some statisticaly significant differences were detected . Various possibilities of applications of typing set of Pseudomonas phages are discussed. Arch Immunol Ther Exp (Warsz), 1988, 36(2), 177 - 84 Studies on phagocytosis of mucoid and nonmucoid variants of Pseudomonas aeruginosa . I . Induction of homologous immunity by nonmucoid strains of P . aeruginosa; Gosciniak G et al.; Monovalent immune sera against somatic antigens (anti-O) have been shown to potentiate phagocytosis exclusively of nonmucoid homologous immunotypes . To obtain polyvalent immunity for all nonmucoid immunotypes of P . aeruginosa, all immunotypes of these bacteria have to be used for immunization. Arch Immunol Ther Exp (Warsz), 1988, 36(2), 167 - 76 Investigation on extracellular slime from Pseudomonas aeruginosa as interferon inducer in mice; Cembrzynska-Nowak M et al.; The investigation concerns interferon (IFN) production in the sera and spleens of 129/Ao/Boy mice induced with Pseudomonas aeruginosa slime extract . Interferon was present in the serum as early as 2 h after i.v . and i.p . injection of the immunogenic dose of the slime - 100 micrograms/mouse . Likewise, in the spleen the same dose induced interferon production at the second hour after its administration . In the spleen interferon was synthetized longer, even up to 7 days . On the other hand, it disappeared from the serum after 24 h . In vitro investigations on interferon induction in peritoneal cells and spleen revealed that after slime extract stimulation, only non-adherent cells are capable of IFN production; while adherent cells are not . Interferon synthesis in peritoneal cells in vitro was much enchanced if for the experiments, cells isolated 2 - 4 h after i.v . administration of mice with Ps . aeruginosa slime extract, were used . Besides, the stimulatory effect of the extract on interferon production was well marked in the Newcastle virus-induced peritoneal cells . For comparison, interferon obtained after induction with slime extract in vivo (in the serum) and in vitro (in peritoneal cells) was tested for its properties . The interferons although both acidstable, displayed significant differences . IFN obtained in vitro from peritoneal cells culture appeared thermolabile and susceptible for neutralization with gamma-globulin of rabbit serum against interferon from Newcastle virus-induced L929 cells (anti-MuIFN alpha/beta) . IFN from serum was thermostabile, undergoing only slight neutralization with anti-MuIFN alpha/beta globulin. Acta Microbiol Pol, 1988, 37(2), 191 - 204 Characterization of the specificity of lipopolysaccharide antigens from seven Fisher's immunotypes of Pseudomonas aeruginosa, using ELISA technique; Trafny EA et al.; Lipopolysaccharides of seven Fisher's immunotypes of P . aeruginosa, extracted by water-phenol method, were fractionated on Sepharose 2B column . On the basis of molecular weight sugar and KDO content, eluents were separated into 4 fractions . An analysis of the antigenic specificity of the chromatographic fractions of seven immunotypes of LPS was carried out, using sera of mice vaccinated with several crude LPS preparations or whole-cell suspensions each of P . aeruginosa immunotypes, by ELISA . The antigenic specificity of fraction 1 and 2 of several immunotypes (with the exception of LPS from immunotype 2) in reaction with mice antisera for crude LPS was shown . Not quite full specificity of fractions 1-3 of all LPS preparations during analysis of these fractions reactivity with antisera to whole P . aeruginosa cells were observed, but specific reactions predominated in all test systems except LPS 2. Scand J Gastroenterol Suppl, 1988, 143, 103 - 9 Significance of immunologic factors in cystic fibrosis; Przyklenk B et al.; We specifically investigated the significance of antibodies directed against pure preparations of lipopolysaccharide antigens and also against elastase of Pseudomonas aeruginosa . Antibodies were detected by an indirect enzyme-linked immunosorbent assay technique both in serum (IgG) and in sputum (sIgA) . Patients with cystic fibrosis (CF) chronically infected with Ps . aeruginosa had significantly higher antibody titers both in serum and sputum than CF patients or non-CF persons not colonized with Ps . aeruginosa . There were differences in the antibody spectrum between the colonized CF group and the two non-colonized control group . The sensitivity was highest for homologous O-specific IgG in serum (91.9%), followed by homologous O-specific sIgA in sputum (79.4%) and sIgA anti-elastase in sputum (66.2%) . O-specific IgG antibodies in serum indicate a previous contact with various O-antigens of Ps . aeruginosa rather than reflect the present condition of the patient . In the evaluation of the current status sIgA O-specific antibodies in sputum are an appropriate indicator, with titers increasing during acute exacerbations and decreasing to normal values subsequently. Pediatrie, 1988, 43(1), 5 - 10 {Mucoviscidosis: what is the cause of bronchitis?}; Bellon G et al.; To this day, there is no explanation as to why chronic airway obstruction develops in cystic fibrosis (CF) . Even if the mucous secretions are considered abnormal, these abnormalities resemble those observed in patients without CF . There is no primary alteration of the ciliated cells and the presence of a CF ciliary inhibitory factor has not yet been established . However, the electrolyte (chloride and sodium) transport abnormalities in airway epithelia can induce a dehydration of bronchial secretions and a slowdown of mucociliary transport in peripheral airways . But this does not explain the specific lung infection and the role of Pseudomonas aeruginosa . No specific biochemical or structural abnormality of the CF-specific bronchial secretions and/or cell membranes has yet been identified . The question therefore remains open: are we dealing with a deficient respiratory tract immunity? The CF coding gene has been localized: could the discovery of a "basic defect", a direct expression of the abnormal gene, explain the electrolyte transport abnormalities, the specific lung infection and other CF manifestations? Resuscitation, 1988 Jan, 16(1), 65 - 74 Role of proteases in patients with acute renal failure and regular hemodialysis therapy; Horl WH et al.; The potential role of proteases in patients with acute renal failure and regular hemodialysis therapy was investigated . Proteases released from blood cells, damaged kidney cortex and different strains of Pseudomonas aeruginosa in patients with septicemia may contribute to an accelerated protein catabolism . The imbalance of the protease-antiprotease system suggests the valve of active antiproteolytic agents in the treatment of these pathologic states . Our own observation of an in vitro suppression of enhanced proteolysis by the administration of alpha 2-macroglobulin seems to support the usefulness of such a procedure (W.H . Horl, C . Gautert, I.O . Auer et al., Am . J . Nephrol., 2 (1982) 32-35) . As long as alpha 2-macroglobulin is not available, the value of its treatment has to be confirmed by the administration of fresh frozen plasma containing alpha 2-macroglobulin . Also the search for other active antiproteolytic agents is required. J Bacteriol, 1988 Jan, 170(1), 155 - 62 Sequence and transcriptional start site of the Pseudomonas aeruginosa outer membrane porin protein F gene; Duchene M et al.; Porin F is one of the major proteins of the outer membrane of Pseudomonas aeruginosa . It forms water-filled pores of variable size . Porin F is a candidate for a vaccine against P . aeruginosa because it antigenically cross-reacts in all serotype strains of the International Antigenic Typing Scheme . We have isolated the gene for porin F from a lambda EMBL3 bacteriophage library by using oligodeoxynucleotide hybridization probes and have determined its nucleotide sequence . Different peptide sequences obtained from isolated porin F confirmed the deduced protein sequence . The mature protein consists of 326 amino acid residues and has a molecular weight of 35,250 . The precursor contains an N-terminal signal peptide of 24 amino acid residues . S1 protection and primer extension experiments, together with Northern (RNA) blots, indicate that the mRNA coding for porin F is monocistronic with short untranslated regions of about 58 bases at the 5' end and about 47 bases at the 3' end . The sequences in the -10 and -35 regions upstream of the transcriptional start site are closely related to the Escherichia coli promoter consensus sequences, which explains why the porin F gene is expressed in E . coli under the control of its own promoter . The amino acid sequence of porin F is not homologous to the different E . coli porins OmpF, OmpC, LamB, and PhoE . On the other hand, a highly homologous region of 30 amino acids between the OmpA proteins of different enteric bacteria and porin F of P . aeruginosa was detected . The core region of the homology to E . coli OmpA had 11 of 12 amino acid residues in common. Infect Immun, 1988 Jan, 56(1), 18 - 23 Mapping of the T-cell recognition sites of Pseudomonas aeruginosa PAK polar pili; Smart W et al.; The polar pili of Pseudomonas aeruginosa consist of a subunit protein, pilin, which is a 144-residue polypeptide that contains a hydrophobic N-terminal region and eight hydrophilic regions distributed throughout the remainder of the molecule . T cells from mice immunized with pili or whole bacteria gave good pilus-specific T-cell proliferation responses . To delineate the T-cell antigenic regions of the pilin, T-cell blasts were generated from lymph nodes of pilus-primed BALB/c mice . These blasts were tested in vitro in T-cell proliferation assays for reactivity against the fragments of the pilin subunit prepared by enzymatic digestion . Citraconylation followed by trypsin digestion (cT) of the pilin subunit cleaved the protein into four fragments, cTI (residues 1 to 30), cTII (residues 31 to 53), cTIII (residues 54 to 120), and cTIV (residues 121 to 144) . The ability to stimulate the T cells was found to reside in the cTI and cTIII regions, but not in the cTII or cTIV regions . A subfragment of cTIII, containing residues 82 to 104, was identified as the major T-cell recognition site within the cTIII region of the pilin molecule . A cross-reactivity was observed between pili from two strains of P . aeruginosa, namely, PAK and PAO, at the T-cell level . This cross-reactivity probably resulted from the sequence homology in the hydrophobic N-terminal region of these two molecules. J Biol Chem, 1987 Dec 15, 262(35), 16914 - 9 Effect of lipid acyl chain length on activity of sodium-dependent leucine transport system in Pseudomonas aeruginosa; Uratani Y et al.; The sodium-dependent leucine transport system of Pseudomonas aeruginosa was reconstituted into liposomes of binary lipid mixtures of dilauroylphosphatidylethanolamine (di(12:0)PE)/phosphatidylcholine (PC) with cis-monounsaturated fatty acid chains (di(n:1)PC) (n = 14-22) or dioleoylphosphatidylethanolamine (di(18:1)PE)/di(n:1)PC (n = 14-22) . Leucine carrier proteins can be activated with phosphatidylethanolamine, whereas activation does not occur in PC-reconstituted vesicles (Uratani, Y., and Aiyama, A . (1986) J . Biol . Chem . 261, 5450-5454) . Na+-dependent counterflow was measured at 30 degrees C as reconstituted transport activity . Proteoliposomes containing di(12:0)PE exhibited high counterflow activity at the PC acyl carbon number (n) of 18 and 20 but no or low activity at n = 14, 16, and 22 . On the other hand, proteoliposomes containing di(18:1)PE exhibited higher transport activity than those vesicles with di(12:0)PE and corresponding di(n:1)PC . A lipid mixture of di(18:1)PE and di(16:1)PC supported maximal activity . These results show that the leucine transport system of P . aeruginosa is dependent on the lipid acyl chain length and suggest that there exists optimal bilayer thickness for maximal carrier activity. Pharm Weekbl Sci, 1987 Dec 11, 9 Suppl, S93 - 6 Treatment of chronic osteomyelitis with ciprofloxacin; Stuyck J et al.; The results of the treatment of twenty-one patients (age 22-66 years) with chronic bone or joint infections with ciprofloxacin were evaluated . The osteomyelitis was secondary to trauma in 12 patients, joint replacement in six, previous acute hematogenous infection in two and osteotomy in one . Stafylococcus aureus (11 times) and Pseudomonas aeruginosa (9 times) were most frequently cultured . The duration of ciprofloxacin therapy averaged 76 days . Concomitant antimicrobial drugs were used in one patient only . Fifteen patients were operated during treatment; in most cases the surgical procedure consisted of a thorough debridement . Nineteen patients could be evaluated . The bacteriological results were as follows: eradication 27; marked reduction 1; eradication with recurrence 1 . Contamination occurred in five patients and superinfection in two, without much influence on the final outcome . The investigator's assessment at the end of the therapy was as follows: complete success in 14 patients and partial success in seven . During the follow-up (3-13 months) the therapy was judged completely successful in 16, partially successful in four and unsuccessful in one . Two patients had minor gastric complaints during therapy and one showed a temporary slight increase in the liver transaminases. Pharm Weekbl Sci, 1987 Dec 11, 9 Suppl, S64 - 7 Ciprofloxacin for respiratory tract infection with Pseudomonas aeruginosa; Haverkorn MJ; Thirty one patients were treated with oral ciprofloxacin for bronchitis with Pseudomonas aeruginosa . Twenty eight patients had permanent and 14 transient risk factors . Nine patients had a hospital infection with Pseudomonas aeruginosa . Sixteen patients were cured, complete or partial, but Pseudomonas aeruginosa persisted or recurred in 19 patients . Patients with hospital infection did better than other patients . There was a significant decrease in in vitro susceptibility of persisting strains of Pseudomonas aeruginosa to ciprofloxacin and a tendency of recovery of susceptibility for the drug after treatment. Pharm Weekbl Sci, 1987 Dec 11, 9 Suppl, S58 - 9 Treatment of respiratory tract infections with pefloxacin in critically ill patients hospitalized in a surgical intensive care unit; Boland DM et al.; Respiratory tract infections were treated with pefloxacin in fifteen patients, who were hospitalized in the intensive care unit and required artificial ventilation . The treatment was successful in ten patients . Development of resistance was observed in Staphylococcus aureus (two times) and Pseudomonas aeruginosa (four times) . No adverse reactions were seen. Pharm Weekbl Sci, 1987 Dec 11, 9 Suppl, S26 - 9 The activity of ciprofloxacin against Pseudomonas aeruginosa in normal and granulocytopenic mice; Mattie H et al.; Ciprofloxacin was studied in vitro and in an experimental thigh infection model in mice to evaluate its efficacy against Pseudomonas aeruginosa in comparison with that of tobramycin . The in vivo experiments were carried out in normal mice as well as mice rendered granulocytopenic by irradiation . The MIC of ciprofloxacin for two Pseudomonas strains was 0.125 mg/l and 0.25 mg/l and that of tobramycin 0.25 mg/l and 4.0 mg/l, respectively . In vitro short-term growth experiments revealed that as far as initial killing rate is concerned, ciprofloxacin was 2.20 times as potent as tobramycin against the first strain and 45.4 times as potent against the second strain . The in vivo experiments were performed by injecting the micro-organism into the thigh muscle and counting colony forming units (CFUs) after several hours of exposure to the antibiotics . The results for irradiated mice indicate that ciprofloxacin was 2.0 times as potent as tobramycin against the first strain and 37.8 times as potent against the second strain, when related to dosage . For normal mice these values were 2.0 and 16.0, respectively, which is more than would be expected from the in vitro experiments because the mean plasma concentrations of tobramycin were about four times higher than those of ciprofloxacin. Pharm Weekbl Sci, 1987 Dec 11, 9 Suppl, S11 - 5 Resistance to quinolones; Mouton RP; Resistance to quinolones is only due to mutations . The mechanism and the range of quinolones involved, depend on the locus of the chromosomal mutation e.g . a mutation in the gyr A locus is associated with resistance due to changes in the gyrase . Using high inocula in vitro, varying, but relatively low mutation rates of resistance to fluoroquinolones have been found (10(-6)-10(-12) . In vitro transfers of bacterial strains in increasing concentrations of quinolones yield parallel increases of the MIC's of most quinolones; however, the MIC's of the most active quinolones like ciprofloxacin usually remain below concentrations achievable in vivo . Exceptions are MIC's for Pseudomonas aeruginosa and staphylococci . Combined resistance to quinolones and other antibiotics was observed after in vitro transfers as well as in mutants (10(-6)-10(-8) isolated from a high inoculum . Changes in the outer membrane proteins have been found in these mutants . Clinical resistance to fluoroquinolones is rare except in Pseudomonas aeruginosa and staphylococci. J Mol Biol, 1987 Dec 5, 198(3), 405 - 16 Reconstituted and native iron-cores of bacterioferritin and ferritin; Mann S et al.; The structural and magnetic properties of the iron-cores of reconstituted horse spleen ferritin and Azotobacter vinelandii bacterioferritin have been investigated by high-resolution transmission electron microscopy, electron diffraction and Mossbauer spectroscopy . The structural properties of native horse spleen ferritin, native Az . vinelandii, and native and reconstituted Pseudomonas aeruginosa bacterioferritins have also been determined . Reconstitution in the absence of inorganic phosphate at pH 7.0 showed sigmoidal behaviour in each protein but was approximately 30% faster in initial rate for the Az . vinelandii protein when compared with horse spleen apoferritin . The presence of Zn2+ reduced the initial rate of Fe(II) oxidation in Az . vinelandii to 22% of the control rate . The iron-cores of the reconstituted bacterioferritins adopt defect ferrihydrite structures and are more highly ordered than their native counterparts, which are both amorphous . However, the blocking temperature for reconstituted Az . vinelandii (22.2 K) is almost identical to that for the native protein (20 K) . Particle size measurements indicate that the reconstituted Az . vinelandii cores are smaller in median diameter than the native cores and this reduction in particle volume (V) offsets the increased magnetocrystalline contribution to the magnetic anisotropy constant (K) in such a way that the magnetic anisotropy barrier (KV), and hence the blocking temperature, is similar for both proteins . Reconstituted horse spleen ferritin exhibits a similar blocking temperature (38 K) to that determined for the native protein, although it is structurally more disordered . The possibility of introducing structural and compositional modifications in both horse ferritin and bacterioferritins by in-vitro reconstitution suggests that these proteins do not function primarily as a crystallochemical-specific interface for core development in vivo. J Trauma, 1987 Dec, 27(12), 1323 - 31 Amelioration of pulmonary pathophysiology of adult respiratory distress syndrome by sulindac, a cyclo-oxygenase inhibitor; Steinberg S et al.; The effects of sulindac, a cyclo-oxygenase inhibitor, were tested in a bacteremic porcine model of acute respiratory failure produced by a continuous infusion of live Pseudomonas aeruginosa . Control groups received either a single intravenous dose of sulindac (6 mg/kg) 20 minutes after baseline determinations or a continuous infusion of Ps . aeruginosa (10(7) CFU/kg/min) beginning at time 0 . The experimental group received both . Sulindac alone had no effect on any hemodynamic or gas exchange parameter . Ps . aeruginosa infusion caused pulmonary hypertension, hypoxemia, increased intrapulmonary shunt fraction, systemic hypotension, and increased extravascular lung water . Sulindac treatment reversed the pulmonary hypertension, hypoxemia, and increased intrapulmonary shunting, prevented the systemic hypotension, but had no effect on the rising extravascular lung water. Eur J Clin Microbiol, 1987 Dec, 6(6), 634 - 6 Selection and counting of aerobic gram-negative bacilli in saliva by the spiral system; Yourassowsky E et al.; A four-month pilot study involving 100 volunteers, 100 hospitalised patients not on antibiotics and 100 patients on antibiotics was performed using a non labor-intensive system involving inoculator, laser colony counter and 14-cm petri dishes containing MacConkey medium to determine the number of aerobic gram-negative bacilli present in saliva . All colonies greater than or equal to 0.75 mm in diameter were found to be aerobic gram-negative bacteria . This was also valid for Pseudomonas aeruginosa, but only after incubation for 48 h . This study showed that the novel and practical technique used can be applied to a large number of saliva specimens, and antibiotics have limited impact on the buccal microflora (intensive care unit excluded). Pediatr Res, 1987 Dec, 22(6), 743 - 7 An immunohistological evaluation of Pseudomonas aeruginosa pulmonary infection in two patients with cystic fibrosis; Speert DP et al.; Pseudomonas aeruginosa is the principal pulmonary pathogen in patients with cystic fibrosis . All attempts to date to prevent or eradicate P . aeruginosa infections in these patients have been unsuccessful . Vaccination against P . aeruginosa has been proposed as a preventive strategy but it has not been adequately evaluated . The purpose of this study was to determine whether P . aeruginosa, present in the lungs of patients with cystic fibrosis, express surface antigens similar to those grown in vitro; this issue is of critical importance when choosing bacterial products as vaccine candidates . Lung sections from two patients who died of the pulmonary complications of cystic fibrosis were studied . Bacteria, both in lung sections and isolated from the lung sections and grown in vitro, reacted strongly with polyclonal and monoclonal antibodies against P . aeruginosa mucoid exopolysaccharide and outer membrane proteins F and H2; this suggested that these antigens are surface exposed in vivo . It was also found that bacteria in both lung sections were associated in situ with IgG, IgA, and C3 but not with IgM or C4. Pediatr Res, 1987 Dec, 22(6), 698 - 702 A mouse model of chronic pulmonary infection with Pseudomonas aeruginosa and Pseudomonas cepacia; Starke JR et al.; A mouse model of chronic pulmonary infection with either Pseudomonas aeruginosa or Pseudomonas cepacia was developed to compare bacteriologic and pathologic features of these infections . Experimental pneumonia was established in Swiss mice by transoral intratracheal inoculation of 10(3)-10(4) colony-forming units of mucoid P . aeruginosa or P . cepacia enmeshed in agarose beads . Unilateral infection with either strain was tolerated without morbidity . By 10 days postinoculation, the mean colony-forming units per infected lung was 3.8 X 10(5) for P . aeruginosa and 1.0 X 10(5) for P . cepacia . Bacterial counts remained stable through 21 days with no significant difference between organisms . Acute and chronic inflammatory histopathologic changes similar to many found in the lungs of cystic fibrosis patients were present in 95% of lung specimens . The changes occurred with both organisms but were more extensive with mucoid P . aeruginosa . This model represents an important tool for study of the contribution of complement, antibody, and adoptive transfer of T cell-mediated immunity to the pathogenesis of chronic pneumonia with Pseudomonas species, and represents the first successful model of chronic pulmonary infection with P . cepacia. J Antibiot (Tokyo), 1987 Dec, 40(12), 1707 - 15 Synthesis and in vitro activity of C-2 quaternary heterocyclic alkylthio carbapenems; Kim CU et al.; The synthesis of new carbapenems having various (substituted) quaternary heterocyclic alkylthio groups at the C-2 position is described . The in vitro antibacterial activity and the dehydropeptidase-I susceptibility were examined . Some of these compounds (e.g., 11, 16, 26 and 27) showed an excellent wide spectrum of in vitro antibacterial activity including activity against Pseudomonas aeruginosa and greater stability than imipenem toward the dehydropeptidase-I. Infect Control, 1987 Dec, 8(12), 495 - 500 Infection control in El Salvador: the Hospital Rosales experience; Marinero Caceres JA et al.; We describe circumstances at the Hospital Rosales, located in San Salvador, El Salvador, and some salient observations from an infection control program begun in 1978 . Findings include overuse of antibiotics, especially of penicillin and chloramphenicol; a predominance of gram-negative rod infections, especially Pseudomonas aeruginosa; a relative infrequency of Staphylococcus aureus infections; an apparent doubling of the mean duration of hospitalization for patients with nosocomial infections compared with other patients (22.1 days versus 11.0 days); documentation and partial correction of deficiencies in aseptic and antiseptic practices; an outbreak of Pseudomonas aeruginosa endophthalmitis traced to the hospital's factory for the manufacturing of intravenous fluids; and attitudinal problems such as the care of patients with rabies on open wards . Prevalence surveys conducted during 1981 and 1986 suggest a dramatic increase in the recent incidence of surgical wound infection (44% upsilon 28%, P less than 0.001) . This latter observation suggests a direct relationship between infection rates and the hardships imposed by poverty and civil war. J Gen Microbiol, 1987 Dec, 133 ( Pt 12), 3581 - 90 Immunoprotective human monoclonal antibodies against five major serotypes of Pseudomonas aeruginosa; Sawada S et al.; Human monoclonal antibodies (Mabs) against the O antigens of Pseudomonas aeruginosa lipopolysaccharides (LPS) were produced by cell fusion between human tonsillar lymphocytes and P3-X63-Ag8-U1 (P3U1) mouse myeloma cells . To obtain human Mabs efficiently, 6 d culture supernatants of pokeweed-mitogen-stimulated lymphocytes (21 cultures from peripheral blood and 76 from tonsils) were assayed by ELISA . Five tonsillar lymphocytes which produced IgG antibody specific for P . aeruginosa LPS were preselected for fusion . The human Mabs, named P1-1 (IgG2, kappa), P5-1 (IgG2, lambda), P7-1 (IgG2, lambda), P8-1 (IgG2, lambda) and P10-1 (IgG2, kappa), bound with high specificity to Homma standard serotype strains A, E, B, G and I, respectively, and recognized O antigens . Each Mab showed opsonophagocytic killing activity of the corresponding serotype strain . Four of the Mabs caused agglutination at a very low concentration; a rather higher concentration of P7-1 was required for this effect . Although all the Mabs conferred type-specific protection against peritoneal infection, the strongly agglutinating Mabs provided better protection than the moderately agglutinating P7-1 . The protective activity of P8-1 was estimated in compromised mice . A low dose (PD50 0.5-0.6 microgram per mouse) of P8-1 prevented subcutaneous infection in burned mice and peritoneal infection in leucopenic mice . All the hybridomas described here could be cultured in serum-free medium, and they have continued to secrete human Mabs for more than 14 months at rates of 10-20 micrograms per 10(6) cells in 24 h . These results suggested that these five human Mabs specific for O antigens might be useful in the prophylaxis and treatment of P . aeruginosa infections. J Antimicrob Chemother, 1987 Dec, 20(6), 825 - 9 Reduced virulence in ciprofloxacin-resistant variants of Pseudomonas aeruginosa strains; Ravizzola G et al.; Pseudomonas aeruginosa strains resistant to ciprofloxacin were obtained from parental strains by serial transfer through subinhibitory concentrations of the drug . They showed reduced virulence for mice, and also increased sensitivity to aminoglycosides. Eur J Clin Microbiol, 1987 Dec, 6(6), 674 - 8 Interaction of the novel penem CGP 31 608 and its enantiomer with type Id beta-lactamase and penicillin-binding proteins; Mett H et al.; The novel penem CGP 31,608 (5R, 6S, 8R) and its enantiomer CGP 32,879 (5S, 6R, 8S) were shown to be essentially stable against hydrolysis by type Id beta-lactamase isolated from Pseudomonas aeruginosa 18S/H . CGP 31 608 was a potent progressive inhibitor of this enzyme (150 = 32 microM), which was only weakly inhibited by CGP 32,879 (150 = 460 microM) . CGP 31,608 had the highest affinity for penicillin-binding protein (PBP) 4 from Escherichia coli K-12 (150 = 1 microgram/ml), followed by PBPs 2 (10 micrograms/ml) and 1A/1Bs (100 micrograms/ml); CGP 32,879 did not inhibit binding of 14C-benzylpenicillin to the PBPs . The steric configuration of the beta-lactam nucleus of penems appears to strongly influence their affinity for beta-lactamases and target PBPs . The balanced spectrum of CGP 31,608 may be explained by its beta-lactamase stability and affinity for several vital PBPs. Antimicrob Agents Chemother, 1987 Dec, 31(12), 1892 - 6 Emergence of resistance to imipenem in Pseudomonas aeruginosa; Lynch MJ et al.; The emergence of resistance to imipenem by Pseudomonas aeruginosa was investigated with four pairs of isolates . Each pair represented pretherapy (susceptible) and posttherapy (resistant) specimens . In all cases, the imipenem-resistant isolates did not demonstrate changed susceptibilities to other beta-lactams . Agarose gel electrophoresis revealed no change in plasmid profiles between any pair of isolates . Sodium dodecyl sulfate-polyacrylamide gel electrophoresis of the Sarkosyl-insoluble membrane protein revealed the loss of an outer membrane protein of apparent molecular mass 48 to 49 kilodaltons in posttherapy strains when grown with imipenem selection (5 micrograms/ml) . There was no significant difference in the binding of {14C}imipenem to the penicillin-binding proteins of the pre- and posttherapy strains . Trichloroacetic acid precipitation of membranes isolated after growth in the presence of {14C}imipenem revealed that significantly less drug was bound to Sarkosyl-soluble membrane protein in three of the four posttherapy strains than the membrane proteins of the respective pretherapy strains . beta-Lactamase activity against imipenem at 100 or 3 microM was not detected in any isolate either with or without induction . These data suggest that resistance to imipenem is associated with the loss of a 48- to 49-kilodalton outer membrane protein accompanied by, in three of four cases, decreased penetration of the antibiotic across the outer membrane. Can J Ophthalmol, 1987 Dec, 22(7), 378 - 80 Metastatic Pseudomonas endophthalmitis following bronchoscopy; Boisjoly HM et al.; Symptoms of uveitis developed in the left eye of a 61-year-old woman 2 weeks after bronchoscopy to investigate hemoptysis . The true diagnosis of metastatic endophthalmitis was unsuspected for 1 month . Both sputum and vitreous samples yielded Pseudomonas aeruginosa when cultured . Despite aggressive medical treatment, subtotal vitrectomy and intraocular injections of antibiotics, enucleation was eventually necessary . To our knowledge this is the first reported case of metastatic endophthalmitis following bronchoscopy . It is also the first report of the concentration of ceftazidime pentahydrate in the vitreous humour of an infected human eye. Vaccine, 1987 Dec, 5(4), 261 - 5 Prospects for the prevention and control of gram-negative nosocomial infections; Cryz SJ Jr; Nosocomial infections of bacterial origin continue to be a leading cause of morbidity and mortality among virtually all hospitalized patient populations . It is estimated that nearly 5% of all hospitalized individuals will acquire an infection during their stay . Approximately 3% of nosocomial infections will contribute to an eventual fatal outcome . Preeminent among nosocomial pathogens are the aerobic Gram-negative bacilli, with Escherichia coli, Pseudomonas aeruginosa and Klebsiella spp . being the causative agents for the majority of life-threatening infections . This review describes the current situation and future prospects for combatting these infections. J Med Microbiol, 1987 Dec, 24(4), 315 - 24 The effect of Pseudomonas aeruginosa cytotoxin and toxin A on human polymorphonuclear leukocytes; Bishop MB et al.; After exposure to cytotoxin or toxin A of Pseudomonas aeruginosa, the ultrastructure of resting and phagocytosing human polymorphonuclear leukocytes (PMNL) and of cells of P . aeruginosa strain 1348A was studied by transmission (TEM) and scanning (SEM) electronmicroscopy, and by light microscopy (LM) after histochemical staining of cytoplasmic granules . Cytotoxin caused marked clumping and destruction of PMNL, pyknotic nuclear changes with bleb formation, and release of cytoplasmic granules; phagocytosis was markedly diminished . In contrast, after exposure to toxin A, PMNL phagocytosed actively, but their cytoplasmic pseudopodia were markedly irregular and their nuclei pyknotic . Colloidal-gold-labelled cytotoxin showed an affinity for the cytoplasmic membranes, nuclei and granules of PMNL . Cytotoxin had no apparent effect on cells of P . aeruginosa strain 1348A but there was polar separation of the cytoplasmic membrane in bacteria exposed to toxin A . Cytotoxin and toxin A appear to be important in the pathogenesis of infections caused by P . aeruginosa. Eur J Epidemiol, 1987 Dec, 3(4), 431 - 5 Prevalence of pyocin types of P . aeruginosa in a university hospital during 1981-1986; Jurado Chacon D et al.; Strains of Pseudomonas aeruginosa isolated from patients in the University of Granada (Spain) from 1981 to 1986 were pyocin-typed in order to determine which types were the most common . The proportions of typable and non typable strains were similar to those obtained by other authors . A high percentage of typable strains were unclassifiable (UC) according to Govan's method . The most frequent types of typable strains were 580 (55 of Govan), 270 (UC), 280 (UC), 570 (UC), 670 (73 of Govan), 113 (10 of Govan), 470 (86 of Govan) and 180 (58 of Govan) . These types were responsible for the appearance of several nosocomial outbreaks during the years of this study . Types 580, 113 and 280 remained constant for these six years; for this reason, they can be considered endemic of our hospital. Infect Immun, 1987 Dec, 55(12), 3204 - 6 Opsonophagocytosis of Pseudomonas aeruginosa treated with antiflagellar serum; Anderson TR et al.; Hyperimmune rabbit flagellar antisera were shown to enhance opsonophagocytosis of Pseudomonas aeruginosa by mouse peritoneal polymorphonuclear leukocytes . This response was specific for flagellar immunoglobulin G as indicated by cross-opsonization experiments. J Antimicrob Chemother, 1987 Dec, 20(6), 815 - 23 The inhibitory effect of sodium alginate on antibiotic activity against mucoid and non-mucoid strains of Pseudomonas aeruginosa; Baltimore RS et al.; The exopolysaccharide of mucoid strains of Pseudomonas aeruginosa (MPA) is chemically similar to alginate, a common polysaccharide of seaweeds . Both polymers have been reported to decrease the diameter of the inhibition zones produced in antibiotic disc diffusion assays . In order to determine whether this phenomenon was due to reduced diffusion of the antibiotic in an agar matrix, or to inhibition of antibiotic activity by sodium alginate, we studied the effect of sodium alginate on the susceptibility of P . aeruginosa strains to antibiotics in disc diffusion assays, as well as in broth and agar dilution assays . Sodium alginate decreased the activity of the aminoglycoside antibiotics, amikacin and gentamicin, against two MPA strains and their non-mucoid derivatives in each of the assays . In broth dilution assays, increase of the calcium ion concentration likewise reduced aminoglycoside activity against P . aeruginosa, but not against Escherichia coli and Staphylococcus aureus . Sodium alginate caused no inhibition of the activity of piperacillin and carbenicillin . The reduction of aminoglycoside activity may have implications for the common failure of these antibiotics in the treatment of pulmonary infections caused by MPA in cystic fibrosis patients, but must be considered only an in-vitro phenomenon at present. J Bacteriol, 1987 Dec, 169(12), 5663 - 7 Characterization of Pseudomonas aeruginosa mutants with altered piliation; Johnson K et al.; The pilus-specific Pseudomonas aeruginosa bacteriophage P04 was used to select spontaneous mutants of strain PAK which have altered piliation . The largest class of phage-resistant mutants synthesized the pilin polypeptide, but did not assemble pili . These mutants are likely to contain mutations in genes required for pilus assembly and not mutations in the pilin structural gene, as they could not be complemented by a normal copy of the pilin gene . In addition, two alterations in pilin gene transcription were found among the mutants--hyperpiliated mutants which overproduce pilin mRNA, and a mutant with temperature-sensitive pilin gene transcription . We also present a model for the regulation of pilin gene transcription by a feedback mechanism sensitive to the relative rates of pilus assembly and disassembly. Med J Aust, 1987 Nov 16, 147(10), 507 - 10 Transplantation of cultured autologous epidermis to a patient with burns; Thompson CH et al.; Explant-derived cultured autologous epidermis was used as a graft in a 41-year-old female patient with burns, the first subject in a clinical trial of the technique . A small full-thickness biopsy specimen which was taken on Day 2 of the hospital admission was used to initiate epidermal cultures, four of which were grafted onto the patient's back and right leg 29 and 35 days later . Three of these epidermal cultures engrafted successfully, in spite of infection with Pseudomonas aeruginosa, which resulted in the loss of some of the conventional, split-thickness meshed autografts that were applied concurrently . The fourth graft, which may have been oriented incorrectly onto the graft bed, was largely unsuccessful, and only small islets of epithelial cells remained after 10 days . The successful grafts produced full-thickness, epidermal coverage with a good cosmetic result and little evidence of contraction during a six-months' follow-up. Biochim Biophys Acta, 1987 Nov 5, 916(1), 38 - 47 The reaction of nitric oxide with copper proteins and the photodissociation of copper-NO complexes; Gorren AC et al.; The reactivity with nitric oxide was investigated for a number of type-1, type-2 and type-3 copper proteins azurin from Pseudomonas aeruginosa (type-1 copper); bovine superoxide dismutase, diamine oxidase from pig kidney and galactose oxidase from Dactylium dendroides (type-2 copper); haemocyanin from Helix pomatia (type-3 copper); the blue oxidases ceruloplasmin from pig serum, and ascorbate oxidase from Cucurbita pepo medullosa . Type-1 copper formed complexes with NO in the oxidised state, which complexes were only fully formed at low temperatures and could be photodissociated at 77K . Complex formation led to the disappearance of the EPR signal of type-1 copper and of the optical absorbance band in the 600 nm region . In azurin, photodissociation caused the reappearance of the original 625 nm absorbance band, but in the blue oxidases, a new band with lower intensity was found at 595 nm instead of the original absorbance band at 610 nm . In all cases, the EPR signal of type-1 copper did not return . These results are best explained by the formation of a photolabile type-1 Cu1+-NO+ complex . They also indicate that in the complex formed, the type-1 copper structure is probably not disrupted, and that after illumination, the nitric oxide molecule is still in the near vicinity of the copper atom . Type-2 copper did not react at all with nitric oxide, and type-3 copper formed complexes with nitric oxide in both the oxidised and the reduced state, but photodissociation of these complexes could not be demonstrated. Biochim Biophys Acta, 1987 Nov 5, 916(1), 112 - 8 Specific cleavage of Pseudomonas cytochrome-c peroxidase by elastase from Pseudomonas aeruginosa; Ronnberg M; The occasional cleavage of the Pseudomonas cytochrome-c peroxidase (ferrocytochrome-c:hydrogen-peroxide oxidoreductase, EC 1.11.1.5) molecule into two well-defined fragments during the preparation of the enzyme is shown to be identical to that caused by elastase isolated from the culture solution of Pseudomonas aeruginosa . A cyanogen bromide fragmentation of proteolytically cleaved and of intact enzyme shows the cleaved peptide bond to be situated in cyanogen bromide fragment II . The amino-acid sequence of this fragment was established by sequencing peptides obtained with trypsin, thermolysin, chymotrypsin and o-iodosobenzoate . It is concluded from the sequence homology that the polypeptide chain of Pseudomonas peroxidase is wrapped around the high-potential heme in a similar manner as in high-potential cytochromes c in general . The specific proteolytic cleavage occurs at a Ser-Val (Leu-Pro) region which is assumed to be the site of attachment between enzyme and membrane . The cleavage of the Ser-Val bond renders the peroxidase molecule enzymatically inactive by impeding the conformational changes essential for the function of the native enzyme. Klin Wochenschr, 1987 Nov 2, 65(21), 1034 - 41 Acute myelofibrosis in megakaryoblastic leukemia with translocation between chromosomes 8 and 14; Winkelmann M et al.; In a 45-year-old woman with severe normochromic anemia (Hb 2.8 g%) an extensive myelofibrosis and infiltration of the bone marrow with small blasts was observed histologically . Cytochemical examination of the blasts showed a negative peroxidase and a strongly positive alpha-NE reaction . PAS reaction was slightly granular positive in the cytoplasmic protuberances of the blasts and in the platelets . Marker analysis yielded no evidence of lymphatic origin of the blasts . In flow-cytometric studies of 230,000 cells a homogeneous 2c blast population could be identified . Cytogenetic analysis revealed an abnormal pseudo-diploid karyotype characterized by 2 acrocentric marker chromosomes caused by a translocation of chromosomes 8 and 14, as usually seen in Burkitt type lymphoma . Finally the reaction product of platelet-specific peroxidase could be demonstrated in the perinuclear cisternae of the endoplasmic reticulum by electron microscopy . Highly elevated beta-thromboglobulin and platelet factor 4 plasma levels were also measured . Following an ineffective treatment with daunoblastine and ARA-C, the patient died of pseudomonas aeruginosa septicemia after having received high-dose ARA-C treatment. J Clin Microbiol, 1987 Nov, 25(11), 2243 - 6 Susceptibility testing of carumonam: interpretive criteria for 30-microgram disk tests and quality control guidelines for disk diffusion and broth microdilution methods; Jones RN et al.; Carumonam 30-microgram disk diffusion tests with 342 gram-negative organisms suggested modifying earlier interpretive zone criteria, i.e., a susceptibility zone diameter of greater than or equal to 23 mm (less than or equal to 8.0 micrograms/ml MIC correlate) and a resistance zone diameter of less than or equal to 17 mm (greater than or equal to 32 micrograms/ml MIC correlate) . Quality assurance guidelines were determined by multilaboratory investigations . Recommended limits were calculated for the gram-negative quality control organisms only . For Escherichia coli ATCC 25922, the recommended limits are 30 to 36 mm and 0.03 to 0.25 micrograms/ml, and for Pseudomonas aeruginosa ATCC 27853, they are 24 to 32 mm and 1.0 to 4.0 micrograms/ml. J Trauma, 1987 Nov, 27(11), 1301 - 4 Pseudomonas cervical osteomyelitis in a polytrauma patient; Maher DP et al.; Cervical osteomyelitis, an uncommon disease, is rarely associated with Pseudomonas organisms in non-drug-users . This report describes a case of cervical vertebral osteomyelitis associated with Pseudomonas aeruginosa pneumonia following panfacial trauma and closed head injury . Delays in diagnosing vertebral osteomyelitis are common because of the nonspecific nature of the history and the initial absence of clinical evidence, both of which may help to foster a generally low index of suspicion. Am J Med, 1987 Nov, 83(5), 829 - 32 Analysis of continuous ambulatory peritoneal dialysis-related Pseudomonas aeruginosa infections; Bernardini J et al.; The outcomes of all continuous ambulatory peritoneal dialysis-related infections due to Pseudomonas aeruginosa (n = 33) were analyzed and compared with the outcomes of infections due to all other microorganisms (n = 663) over a seven-year period . There were 16 catheter infections (exit site or tunnel infection or both), seven episodes of peritonitis, and 10 episodes of catheter infections associated with peritonitis due to P . aeruginosa . Catheters were removed in 58 percent (19 of 33) of the infections due to P . aeruginosa, but in only 16 percent (104 of 663) of the infections due to other organisms (p less than 0.01) . All P . aeruginosa catheter infections associated with P . aeruginosa peritonitis resulted in catheter loss . P . aeruginosa catheter infections not associated with peritonitis also often did not resolve with antibiotic therapy (nine of 16 or 56 percent of catheters removed compared with 42 of 317 or 13 percent of catheters removed for other organisms, p less than 0.01) . However, P . aeruginosa peritonitis episodes that were not associated with a catheter infection were no more likely to result in catheter loss than were peritonitis episodes due to other organisms (one of seven compared with 37 of 256, 14 percent for both) . It is concluded that catheter infections due to P . aeruginosa with or without associated peritonitis usually require catheter removal . Conversely, P . aeruginosa peritonitis without a catheter infection often does not require catheter removal. Chest, 1987 Nov, 92(5), 844 - 8 Tobramycin in patients with cystic fibrosis . Adjustment in dosing interval for effective treatment; Horrevorts AM et al.; The efficacy of the dosing regimen of tobramycin was investigated in 28 patients with cystic fibrosis who had an acute exacerbation of chronic pulmonary infection with Pseudomonas aeruginosa . The initial dose of tobramycin was 3.3 mg/kg of body weight three times daily (ie, 10 mg/kg/day) . A highly significant relationship was found between the serum concentration of tobramycin before the dose and the change in the forced expiratory volume in one second (FEV1), both measured on the tenth day of treatment (rs = 0.75; p less than 0.001) . In nine of the 16 patients who had a six-hour serum concentration of 1 mg/L or less on the tenth day of treatment, the eight-hour dosing interval of tobramycin was shortened to achieve a serum concentration of tobramycin of about 1 mg/L before the dose . In the other seven patients, the dosage of tobramycin was not changed . On the 20th day, seven of the nine patients in whom the dosing interval was shortened exhibited an increase in FEV1 of 20 percent or more . Such an increase was observed only in one of the seven patients in whom the dosing interval was not reduced (p less than 0.05) . We conclude that individualizing the dosage of tobramycin in patients with cystic fibrosis results in a better clinical outcome. Arzneimittelforschung, 1987 Nov, 37(11), 1273 - 6 {The effect of immunoglobulin M-enriched intravenous immunoglobulins against bacterial infections and on the neutralization of bacterial toxins}; Dichtelmuller H et al.; Studies on the Efficacy of Immunoglobulin M Enriched Intravenous Immunoglobulins against Bacterial Infections and in Neutralization of Bacterial Toxins . An essential component of the new i.v . immunoglobulin product Pentaglobin is immunoglobulin M (IgM), which is concentrated in this preparation . The efficacy of this IgM containing preparation in comparison to conventional i.v . immunoglobulins was demonstrated in mouse protection tests and by in vitro neutralization of bacterial toxins . The IgM containing immunoglobulin preparation has significantly higher protection rates against gram-positive and gram-negative bacteria in mouse protection tests compared to immunoglobulin G (IgG) preparations . Bacterial toxins of Pseudomonas aeruginosa and Staphylococcus aureus are likewise more effectively neutralized by the IgM containing immunoglobulin preparation. Aust N Z J Surg, 1987 Nov, 57(11), 871 - 3 Pseudomonas osteomyelitis of the spine . Report of a case not associated with drug abuse; Breit R et al.; Pseudomonas aeruginosa, as a cause of vertebral osteomyelitis, has previously been described as occurring in drug abusers . Various empirical methods of treatment have been employed without good follow-up studies . This case report provides a radiological and clinical evolution of pseudomonas vertebral osteomyelitis together with a successful treatment regimen in a 73 year old man who had spontaneous onset of the disease. J Antimicrob Chemother, 1987 Nov, 20(5), 639 - 44 The inoculum effect with gram-negative bacteria in vitro and in vivo; Davey PG et al.; The in-vitro MICs and MBCs of ciprofloxacin, cefoperazone, ceftazidime, ceftriaxone, gentamicin and imipenem were measured for five strains each of Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa with standard and high inocula . The MBC was raised more than the MIC at the higher inoculum for all the drugs except ciprofloxacin . However, the MBC of imipenem against P . aeruginosa was increased relatively little at the higher inoculum in contrast to the findings with other beta-lactam drugs . In a rabbit model of endophthalmitis both cefoperazone and imipenem were markedly more bactericidal against a high inoculum of K . pneumoniae than would have been predicted from the results of in-vitro time kill curve studies . We conclude that the therapeutic relevance of the inoculum effect remains to be proved. Acta Paediatr Scand, 1987 Nov, 76(6), 955 - 61 Management of Pseudomonas aeruginosa lung infection in Danish cystic fibrosis patients; Pedersen SS et al.; The annual mortality rate of cystic fibrosis patients with chronic Pseudomonas aeruginosa lung infection at the Danish CF-centre ranged from 10 to 20% in the years 1970-1975 . In this period the patients received antipseudomonal chemotherapy only during acute exacerbations of infection . From 1976 99 patients acquired chronic P . aeruginosa infection and were given regular and intensive antipseudomonal treatment 3-4 times per year . The patients were followed for 612 patient-years; 7 died and the 10-year survival rate after onset of P . aeruginosa infection was 90% +/- 4% . The annual mortality rate is now 1-2% . Although precipitating antibodies against P . aeruginosa increased significantly, pulmonary function did not deteriorate with duration of infection . Cross-infection between patients caused an increased incidence of chronic P . aeruginosa infection which was reduced by hygienic measures. J Appl Physiol, 1987 Nov, 63(5), 1829 - 36 Effect of cyclooxygenase blockade on gas exchange and hemodynamics in Pseudomonas pneumonia; Hanly P et al.; Acute bilateral Pseudomonas aeruginosa pneumonia was induced in 10 anesthetized dogs, after which five dogs received intravenous indomethacin (2 mg/kg) (indomethacin group), whereas five others were infused with saline (2 ml/kg) (control group) . Plasma levels of 6-ketoprostaglandin F1 alpha(6-keto-PGF1 alpha) and thromboxane B2 (TxB2), stable metabolites of prostacyclin (PGI2) and thromboxane A2 (TxA2), respectively, were measured by radioimmunoassay . Although TxB2 levels were not different before and after inoculation in either group, 6-keto-PGF1 alpha levels increased from their base-line value in each animal as pneumonia developed (indomethacin group: less than 100 to 330 +/- 90 pg/ml; control group: less than 100 to 630 +/- 300 pg/ml) . Both prostaglandins fell to less than 100 pg/ml in each dog after indomethacin infusion, whereas they remained elevated in the control group after infusion of normal saline . Perfusion of consolidated lung regions (Qp/QT), measured with radioactive microspheres and expressed as a percent of total pulmonary blood flow, was dramatically reduced after indomethacin (35 +/- 3 to 16 +/- 1%) with consequent improvement in pulmonary shunt (Qs/QT: 30 +/- 8 to 18 +/- 6%) and arterial O2 tension (PaO2: 123 +/- 25 to 274 +/- 77 Torr) . These parameters remained unchanged or deteriorated further in the control group after infusion of saline . Three additional dogs with Pseudomonas pneumonia were studied in which the indomethacin-induced reduction in Qp/QT was substantially but not completely reversed by intravenous infusion of PGI2.(ABSTRACT TRUNCATED AT 250 WORDS) J Gen Microbiol, 1987 Nov, 133 ( Pt 11), 3257 - 63 Enzymic basis for leakiness of auxotrophs for phenylalanine in Pseudomonas aeruginosa; Berry A et al.; The dual enzymic routes for phenylalanine biosynthesis that exist in Pseudomonas aeruginosa complicate the isolation of phenylalanine auxotrophs . Mutants blocked in each of the various phenylalanine-pathway steps are essential for full appreciation of the physiological nature and gene-enzyme relationships of this biochemical system . A leaky phenylalanine-requiring mutant of P . aeruginosa (PAT1051) was found to lack the bifunctional P-protein (chorismate mutase-prephenate dehydratase), but retained the monofunctional isozyme species of chorismate mutase (chorismate mutase-F) as well as cyclohexadienyl dehydratase (components of the arogenate 'overflow' route to phenylalanine) . This is the first mutant of P . aeruginosa shown to be deficient in any enzyme specific for phenylalanine synthesis . It is concluded that although the arogenate pathway has the demonstrated potential to overproduce phenylalanine, the substrate levels normally available to the arogenate pathway in the wild-type are inadequate to satisfy the full metabolic demand for phenylalanine. J Gen Microbiol, 1987 Nov, 133 ( Pt 11), 3159 - 64 Multiple enzyme forms of glyceraldehyde-3-phosphate dehydrogenase in Pseudomonas aeruginosa PAO; Rivers DB et al.; Both NAD- and NADP-dependent glyceraldehyde-3-phosphate dehydrogenase (G3PDH) (EC 1.2.1.12) activities were detected in glucose-grown cells of Pseudomonas aeruginosa strain PAO . After growth on gluconeogenic substrates such as citrate, the activity of the NAD-G3PDH was reduced severalfold in contrast to little change for the NADP-G3PDH . The two G3PDH activities could be separated by ammonium sulphate fractionation . PAGE revealed the presence of two G3PDH isoenzymes of 140 (NADP-specific) and 315 (NAD-specific) kDa . Slight differences were observed in the thermostabilities and pH optima of the two enzymes whereas the regulation of their activities by various compounds varied strongly . The NADP-G3PDH enzyme was activated by ATP, reduced NAD, and fructose 6-phosphate . It was inhibited by fructose 1,6-diphosphate and 6-phosphogluconate . The NAD-G3PDH enzyme was inhibited by ATP, reduced NAD, and 6-phosphogluconate; it was slightly activated by reduced NADP . The possible roles of these isoenzymes in the control of hexose catabolism and gluconeogenesis in P . aeruginosa are discussed. J Gen Microbiol, 1987 Nov, 133 ( Pt 11), 3099 - 107 Plasmid transfer between strains of Pseudomonas aeruginosa on membrane filters attached to river stones; Bale MJ et al.; A naturally occurring mercury-resistance, conjugative plasmid, designated pQM1, was isolated from a bacterial population on the surface of stones from a river using Pseudomonas aeruginosa as a recipient . This was a narrow-host-range plasmid {IncP-13; 165 MDa; Tra+, Hgr, fluorescein mercuric acetater, merbrominr, Phi(E79), UVr} confined to some Pseudomonas spp . It was used to demonstrate transfer between bacteria on stones in laboratory microcosm experiments and in situ . Transfer occurred (3.3 X 10(-1) to 6.8 X 10(-9) per recipient) at all the temperatures used (6-20 degrees C), although frequencies were lower in the cold . Nutrient status also affected transfer frequency, rich conditions promoting transfer . The presence of competing bacteria in the natural epilithon lowered transfer frequencies, but when unscrubbed stones were heat treated, transfer was enhanced, perhaps because of nutrient release from the heated epilithon. J Gen Microbiol, 1987 Nov, 133 ( Pt 11), 3081 - 91 Transcription and expression of the exotoxin A gene of Pseudomonas aeruginosa; Chen ST et al.; The exotoxin A genes from Pseudomonas aeruginosa strains PA103 and PAO1 have been independently cloned in a pUC9-derived plasmid . In a non-toxigenic mutant of PAO1 as host, the cloned genes directed the synthesis of intact exotoxin A that expressed ADP-ribosyltransferase activity upon treatment with urea and dithiothreitol . Western-blot analysis of culture supernatants identified a polypeptide of 67 kDa, the molecular mass of intact exotoxin A . There was an approximately 15-fold increase in the toxin yield from P . aeruginosa cells carrying a cloned PA103 gene compared to PA103, and a 40-fold increase in the yield of toxin gene yielded about four times more toxin than those carrying the cloned PAO1 gene . Toxin expression was correlated with the presence of a transcript that was initiated 88 bp upstream from the translational start site . Little or no messenger RNA from either cloned gene could be detected in an Escherichia coli host, or in a P . aeruginosa host grown in the presence of 0.1 mM-Fe2+, a condition that inhibits toxin expression . The nucleotide sequences of two regions, each of approximately 500 bp, near the 5' and 3' termini of the structural gene were established . In these regions, three exotoxin A gene from PAO1 has ten base-pair differences compared to the PA103 gene, three in the non-coding region, and seven in the structural gene, four of which should lead to amino-acid differences . No apparent sequence similarities were found between the inferred promoter region of the exotoxin A gene and that of other Pseudomonas genes, nor with the consensus sequence of E . coli promoters. Infection, 1987 Nov-Dec, 15(6), 469 - 70 Selective pressure of antistaphylococcal chemotherapeutics in favour of Pseudomonas aeruginosa in cystic fibrosis; Bauernfeind A et al.; Pseudomonas aeruginosa is insensitive against the majority of oral chemotherapeutics active against staphylococci . During application of such compounds in patients colonized by P . aeruginosa the concentration of P . aeruginosa increased in the majority of treatment episodes by factors between 2.5 and 50000 . So, from a microbiological point of view the application of purely antistaphylococcal drugs should not be used prophylactically against staphylococci. Antimicrob Agents Chemother, 1987 Nov, 31(11), 1803 - 8 Resistance occurring after fluoroquinolone therapy of experimental Pseudomonas aeruginosa peritonitis; Michea-Hamzehpour M et al.; Resistance emerging after fluoroquinolone therapy was investigated in a murine model of Pseudomonas aeruginosa infection . Mice were infected intraperitoneally by one of six strains and treated with pefloxacin or ciprofloxacin . In mice challenged with a low inoculum (1.6 X 10(5) CFU), no resistance occurred . With a higher inoculum (1.5 X 10(8) CFU) and after a single dose of antibiotic, posttherapy (PT1) strains with decreased susceptibility to quinolones (4- to 32-fold less) were isolated at a variable rate . The presence of talcum (125 mg) in the peritoneal cavity increased the risk of resistance after therapy . Pefloxacin (25 or 200 mg/kg) and ciprofloxacin (25 mg/kg) yielded similar resistance rates (61 to 77%), but ciprofloxacin (10 mg/kg) produced more resistance (83%) than did ciprofloxacin (50 mg/kg) (44%) (P less than 0.02) . Combined with a quinolone, ceftazidime (P less than 0.001) or amikacin (P less than 0.01), but not piperacillin, reduced the emergence of resistance . After several doses of ciprofloxacin, it was found that 25-mg/kg doses every 12 h produced more resistance than did 25-mg/kg doses every 8 h or 50-mg/kg doses every 12 h . Compared with the preceding experiments using parent strains, ciprofloxacin and pefloxacin were less efficient in killing bacteria in mice infected with PT1 strains . Moreover, in one of these mice, a highly resistant PT2 strain (64-fold MIC increase for the quinolones) emerged . Besides increased MICs of the quinolones, there was a two- to eightfold increase in imipenem MIC for all PT1 and PT2 strains without alteration of other beta-lactam and aminoglycoside susceptibility . Some PT1 strains also showed a decreased susceptibility to trimethoprim and chloramphenicol . During therapy with a quinolone, resistance can emerge rapidly, especially when there is a large number of bacteria or a foreign body present . This risk may depend on the dosing schedule and may be reduced by combined therapy. Antimicrob Agents Chemother, 1987 Nov, 31(11), 1750 - 5 Bactericidal interactions of a beta-lactam and beta-lactamase inhibitors in experimental Pseudomonas aeruginosa endocarditis caused by a constitutive overproducer of type Id beta-lactamase; Bayer AS et al.; We investigated the in vitro and in vivo effects of a combination of a beta-lactam (ceftazidime) and a beta-lactamase inhibitor (dicloxacillin) to synergistically kill a ceftazidime-resistant variant, Pseudomonas aeruginosa PA-48, which overproduces type Id cephalosporinase constitutively . In vitro, dicloxacillin plus ceftazidime exerted bactericidal synergy at approximately 10(5) CFU/ml of inoculum (but not at approximately 10(7)-CFU inoculum), whereas other beta-lactamase inhibitors (sulbactam, clavulanic acid) showed no enhanced killing of PA-48 when combined with ceftazidime at clinically achievable levels for each agent . Dicloxacillin was a potent competitive inhibitor of the extracted Id cephalosporinase from strain PA-48 in short-term comixture studies (less than 10 min {Ki = 2 nM}); in contrast, longer-term comixture studies (90 min) indicated that dicloxacillin functions as a competitive substrate for the enzyme . Growth of PA-48 cells in the presence of dicloxacillin (12.5 to 100 micrograms/ml) had no significant effect on the production rates or functional activity of the Id enzyme . In experimental aortic valve endocarditis due to the ceftazidime-resistant variant (PA-48), rabbits received either no therapy, ceftazidime (25 mg/kg intramuscularly, every 4 h), or ceftazidime plus dicloxacillin (200 mg/kg intramuscularly, every 4 h) . The combination regimen reduced mean bacterial densities of PA-48 within cardiac vegetations significantly below those in the other groups at both days 3 and 6 of treatment (P less than 0.005) . However, mean vegetation bacterial densities remained greater than 6 log10 CFU/g in the combined treatment group . This modest in vivo synergistic effect (as compared to striking in vitro synergy at approximately 10(5)-CFU inoculum) most likely reflects the high densities of PA-48 achieved in vivo within cardiac vegetations (greater than 8 log10 CFU/g). J Med Microbiol, 1987 Nov, 24(3), 263 - 5 Temperature-dependent expression of the chromosomal beta-lactamase gene in a strain of Pseudomonas aeruginosa; Hewinson RG et al.; A strain of Pseudomonas aeruginosa (3-Post) was resistant to cefsulodin and ceftazidime at 37 degrees C but sensitive at 20 degrees C . Resistance was mediated by chromosomally-encoded beta lactamase which was synthesised at a high level during growth above 30 degrees C but at a low, inducible level during growth below 27 degrees C. J Bacteriol, 1987 Nov, 169(11), 4962 - 6 Exotoxin A of Pseudomonas aeruginosa: active, cloned toxin is secreted into the periplasmic space of Escherichia coli; Douglas CM et al.; We subcloned the structural gene for exotoxin A (ETA) of Pseudomonas aeruginosa in front of the tac promoter in an Escherichia coli expression vector and studied the intracellular location and properties of the protein product . The E . coli K-12 strain that carried this recombinant plasmid produced an immunoreactive protein that was identical to authentic ETA in size and in cytotoxic and ADP-ribosyl transferase activities per unit of immunoreactive material . The protein was predominantly in the periplasmic fraction; and a mutation in the secA gene blocked secretion, processing, and conversion of the protein to a fully toxic conformation . The results indicate that expression of the ETA gene in E . coli yields native ETA, which is localized within the periplasmic space . This organism may therefore serve as a useful host for studying structure and function in ETA. Infect Immun, 1987 Nov, 55(11), 2854 - 6 Production of monoclonal antibodies against serotype strains of Pseudomonas aeruginosa; Lam JS et al.; A panel of 22 monoclonal antibodies against 8 of the 17 International Antigenic Typing Scheme (IATS) serotypes of Pseudomonas aeruginosa was produced . The antibodies were characterized for cross-reactivities, isotypes, titers, and epitope specificities . The results complemented those of our previous study and marked the completion of a set of monoclonal antibodies for serotyping P . aeruginosa. Infect Immun, 1987 Nov, 55(11), 2841 - 3 Colonial dissociation and susceptibility to phagocytosis of Pseudomonas aeruginosa grown in a chamber implant model in mice; Kelly NM et al.; Pseudomonas aeruginosa strains were grown in 1-cm plastic chambers sealed at both ends with porous Millipore filters and implanted in the peritonea of mice . Mucoid and nonmucoid strains of P . aeruginosa isolated from a patient with cystic fibrosis largely retained their phenotypes when grown for up to 1 year in this in vivo system, although colonial dissociation occurred, as observed in chronic lung infections of patients with cystic fibrosis . In the absence of added opsonins, P . aeruginosa M2 cells taken directly from the in vivo system were significantly more susceptible to phagocytosis than were the same P . aeruginosa cells after being washed in buffer . Phagocytosis of in vivo-grown P . aeruginosa cells could be further enhanced by using a porin protein F-specific monoclonal antibody. Mol Microbiol, 1987 Nov, 1(3), 377 - 80 Expression of multiple types of N-methyl Phe pili in Pseudomonas aeruginosa; Elleman TC et al.; The nature of pili synthesized by Pseudomonas aeruginosa when plasmid-borne genes of homologous pilins from Bacteroides nodosus are introduced as thermoregulated expression systems has been ascertained . Expression of B . nodosus pili inhibited the production of indigenous P . aeruginosa pili, and an organism harbouring pilin genes from two strains of B . nodosus produced two serologically distinct populations of pili on each cell . Simultaneous production of both indigenous and foreign pili was achieved by partial induction of expression . Homogeneity in pilus structure suggests either that there is an exclusive specificity of interaction between identical pilin subunits in pilus assembly, or that each pilus is produced from the translation products of a single messenger RNA molecule, with translation and pilus assembly closely coupled. J Bacteriol, 1987 Nov, 169(11), 4967 - 71 Exotoxin A of Pseudomonas aeruginosa: substitution of glutamic acid 553 with aspartic acid drastically reduces toxicity and enzymatic activity; Douglas CM et al.; Glutamic acid 553 of Pseudomonas aeruginosa exotoxin A (ETA) has been identified by photoaffinity labeling as a residue within the NAD binding site (S.F . Carroll and R.J . Collier, J . Biol . Chem . 262:8707-8711, 1987) . To explore the function of Glu-553 we used oligonucleotide-directed mutagenesis to replace this residue with Asp in cloned ETA and expressed the mutant gene in Escherichia coli K-12 . ADP-ribosylation activity of Asp-553 ETA in cell extracts was about 1,800-fold lower and toxicity for mouse L-M929 fibroblasts was at least 10,000-fold lower than that of the wild-type toxin . Extracts containing Asp-553 ETA inhibited the cytotoxicity of authentic ETA on L-M929 fibroblasts, suggesting that the mutant toxin competes for ETA receptors . The results indicate that Glu-553 is crucial for ADP-ribosylation activity and, consequently, cytotoxicity of ETA . Substitution or deletion of this residue may be a route to new ETA vaccines. Mol Biol (Mosk), 1987 Nov-Dec, 21(6), 1497 - 503 {Localization of canonical single-strand breaks in DNA of the Pseudomonas aeruginosa bacteriophage phi kF77}; Kulakov LA et al.; Bacteriophages phi k of P . aeruginosa were characterized by the presence of T4 DNA-ligase-repaired, single-chain breaks in their genome . A restriction map was constructed for one of these phages (phi kF77) with restriction endonucleases SalI, HindIII, EcoRI, MluI, XbaI and ClaI . phi kF77 DNA was resistant to the cleavage by BamHI, BglII, HpaI, PstI, PvuII and XhoI endonucleases . Single-chain breaks were mapped by means of electron microscopy of partially denatured DNA molecules, electrophoretic studies of denatured DNA and S1-analysis . Four major nicks were thus located which were revealed in 33 to 83% of DNA molecules . On the basis of mutual hybridization of single-strand DNA fragments it was shown that all nicks are located in one of the phi kF77 DNA chains . S1-treated hybrids of 32P-labeled single-strand fragments with intact DNA chain were used for DNA orientation . The physical map of phi kF77 DNA was constructed. Biochim Biophys Acta, 1987 Oct 17, 921(3), 595 - 8 Inhibition of acyl-CoA synthetase by triacsins; Tomoda H et al.; Triacsin A, 1-hydroxy-3-(E,E-2',4'-undecadienylidine) triazene and triacsin C, 1-hydroxy-3-(E,E,E-2',4',7'-undecatrienylidine) triazene are potent inhibitors of acyl-CoA synthetase (EC 6.2.1.3) . The concentrations of triacsin A required for 50% inhibition of acyl-CoA synthetase from Pseudomonas aeruginosa and from rat liver are 17 and 18 microM, and those of triacsin C are 3.6 and 8.7 microM, respectively . Kinetic analysis indicates that inhibition of triacsin A is non-competitive with respect to the two substrates ATP and coenzyme A, but is competitive with respect to long-chain fatty acids . The apparent Ki value is 8.97 microM when oleic acid is used as substrate . Acid hydrolysis of triacsins results in corresponding polyenic aldehydes with no activity . This suggests that the N-hydroxytriazene moiety is essential for inhibitory activity against acyl-CoA synthetase. Cancer, 1987 Oct 15, 60(8), 1891 - 5 The value of prophylactic antibiotics during the insertion of long-term indwelling silastic right atrial catheters in cancer patients; Al-Sibai MB et al.; Over a 3.5 year period from August 1982 to December 1985, 200 Hickman catheters (Evermed, Medina, WA) were inserted into patients at the King Faisal Specialist Hospital and Research Centre (KFSHRC), Riyadh, Saudi Arabia . One hundred sixty catheters were placed in patients with malignant disease, many of whom were immunosuppressed at the time of catheter insertion . Seventy of 160 (44%) patients received prophylactic antibiotics and 90 (56%) did not . The mean age of each group was 23 years (range, 2 to 70 years), and the patients in each group were statistically similar in sex, underlying disease, and routine preoperative hematologic and biochemical evaluation . Exit-site wound infections occurred in 50 of 90 (55.5%) patients who did not receive prophylaxis and in 12 of 70 (17%) patients who received prophylaxis (P less than 0.0001) . There was no statistically significant difference in the incidence of tunnel and incision site infections . The mean duration of antibiotic prophylaxis was 2.9 days (SD, 1.2 days) . Organisms cultured from catheter associated infections, included Staphylococcus epidermidis 36, S . aureus 30, Klebsiella pneumoniae 1, Pseudomonas aeruginosa 3, Escherichia coli 1, and diphtheroids non-CDC-JK 3 . Vancomycin was used as antibiotic prophylaxis in 64 patients, Kefzol (Eli Lilly, Indianapolis, IN) in one, oxacillin in three, nafcillin in one, and Septra (Burroughs Wellcome, Research Triangle Park, NC) in one . The data indicate that the use of intravenous antibiotic prophylaxis significantly reduces exit site infection and may reduce both tunnel and incision site infection . Prophylactic antibiotic coverage should be provided to patients during insertion of long-term indwelling right atrial catheters. J Appl Physiol, 1987 Oct, 63(4), 1487 - 92 Pathological supply dependence of O2 uptake during bacteremia in dogs; Nelson DP et al.; When systemic delivery of O2 {QO2 = cardiac output X arterial O2 content (CaO2)} is reduced, the systemic O2 extraction ratio {(CaO2-concentration of O2 in venous blood/CaO2} increases until a critical limit is reached below which O2 uptake (VO2) becomes limited by delivery . Many patients with adult respiratory distress syndrome exhibit supply dependence of VO2 even at high levels of QO2, which suggests that a peripheral O2 extraction defect may be present . Since many of these patients also suffer from serious bacterial infection, we tested the hypothesis that bacteremia might produce a similar defect in the ability of tissues to maintain VO2 independent of QO2, as QO2 reduced . The critical O2 delivery (QO2crit) and critical extraction ratio (ERcrit) were compared in a control group of dogs and a group receiving a continuous infusion of Pseudomonas aeruginosa (5 x 10(7) organisms/min) . Dogs were anesthetized, paralyzed, and ventilated with room air . Systemic QO2 was reduced in stages by hemorrhage as hematocrit was maintained . At each stage, systemic VO2 and QO2 were measured, and the critical point was determined from a plot of VO2 vs . QO2 . The mean QO2crit and ERcrit of the bacteremic group (11.4 +/- 2.2 ml.min-1.kg-1 and 0.51 +/- 0.09) were significantly different from control (7.4 +/- 1.2 and 0.71 +/- 0.10) (P less than 0.05) . These results suggest that bacterial infection can reduce the ability of peripheral tissues to extract O2 from a limited supply, causing VO2 to become limited by O2 delivery at a stage when a smaller fraction of the delivered O2 has been extracted.(ABSTRACT TRUNCATED AT 250 WORDS) Arch Ophthalmol, 1987 Oct, 105(10), 1418 - 20 Transscleral iontophoresis as an adjunctive treatment for experimental endophthalmitis; Barza M et al.; We examined the efficacy of transcleral iontophoresis as an adjunct to intravitreal injection in the treatment of experimental Pseudomonas endophthalmitis in rabbits . Animals received no antibacterial treatment (untreated controls; group 1), a single intravitreal injection of 100 micrograms of gentamicin sulfate (group 2), or the same dose of gentamicin sulfate along with two treatments of transscleral iontophoresis given 24 and 48 hours after the intravitreal injection (group 3) . Treatment was initiated 16, 24, or 48 hours after the induction of infection . For each interval from infection to treatment, there was a lower bacterial count and a higher rate of sterilization in the eyes in group 3 than in group 2; both treated groups had better outcomes than the untreated controls . These data suggest that transscleral iontophoresis could be clinically useful as a supplement to intravitreal injection for a refractory type of endophthalmitis such as that caused by Pseudomonas aeruginosa. J Antimicrob Chemother, 1987 Oct, 20(4), 585 - 94 The efficacy and safety of ciprofloxacin and ofloxacin in chronic Pseudomonas aeruginosa infection in cystic fibrosis; Jensen T et al.; The clinical efficacy and safety of ciprofloxacin and ofloxacin were compared in a prospective, randomized double blind, placebo combined cross-over study in 26 adult cystic fibrosis patients with chronic broncho-pulmonary Pseudomonas aeruginosa infection . Active treatment consisted of ciprofloxacin 750 mg orally twice daily or ofloxacin 400 mg orally twice daily; both treatments were given for 14 days, with three months between treatment periods; 21 patients completed both treatment periods . Treatment with both ciprofloxacin and ofloxacin was associated with a good clinical response as judged by clinical score, lung function tests and inflammatory parameters; no difference between ciprofloxacin and ofloxacin was found . Adverse reactions were seen in nine of 24 patients who received ciprofloxacin and in six of 23 who received ofloxacin . The majority were dyspeptic reactions or photosensitivity . No serious adverse reactions occurred . Three cases of treatment failure were found, one of which was associated with development of resistant P . aeruginosa during ofloxacin treatment . The mean MIC of both drugs increased during treatment but returned to pretreatment values within three months . Ciprofloxacin and ofloxacin seem to be valuable agents for intermittent treatment of chronic P . aeruginosa lung infection in adult cystic fibrosis patients. Br J Dis Chest, 1987 Oct, 81(4), 356 - 60 A controlled trial of nebulized aminoglycoside and oral flucloxacillin versus placebo in the outpatient management of children with cystic fibrosis; Carswell F et al.; Six children with cystic fibrosis who had persistently had Pseudomonas aeruginosa isolated from their respiratory tract, completed a double-blind cross-over comparison of oral flucloxacillin and nebulized aminoglycoside versus double placebo . The patients had higher FEV1 results at the end of the month of active treatment than after the month of placebo. Eur J Respir Dis, 1987 Oct, 71(4), 239 - 43 Ceftazidime treatment of chronic Pseudomonas infection in patients with cystic fibrosis; Fluge G et al.; Twenty-one patients with cystic fibrosis (CF), aged 1-18 years, with chronic lower respiratory tract infection caused by Pseudomonas aeruginosa, received 38 treatment courses of ceftazidime of 10-14 days duration . A favorable clinical response was observed in 28 of the 38 treatment courses . The minimal inhibitory concentration values of ceftazidime for the Pseudomonas isolates were concentrated around 0.5-1.0 mg/l, although a wide range of sensitivities was found (less than 0.03-32 mg/l) . P . aeruginosa was eliminated after five treatment courses, but recurred after 1 month in four of these patients . The organism was permanently eradicated in one patient until his death 8 months later . Ceftazidime was well tolerated . The doses used in this study (50 mg/kg body weight i.v . twice daily) should probably be increased in order to achieve better microbiological response. Clin Pharmacokinet, 1987 Oct, 13(4), 228 - 53 Antibiotic pharmacokinetics in cystic fibrosis . Differences and clinical significance; de Groot R et al.; Antibiotics are administered to cystic fibrosis patients for chronic endobronchial infection complicated by frequent exacerbations . Agents active against Staphylococcus aureus, Pseudomonas aeruginosa or both are administered . Serum antibiotic concentrations were measured in cystic fibrosis patients in an effort to optimise antibiotic dose and frequency . This led to the observation that cystic fibrosis subjects had (in general) a larger Vd and increased total body clearance of beta-lactams and aminoglycosides