Surgical site infections in liver recipients in the early posttransplantation period: etiological agents and susceptibility profiles.

OBJECTIVE: This study evaluated the frequency of microbial isolates and their susceptibility profiles from cultures at the surgical site of 83 liver recipients in the early posttransplantation period. PATIENTS AND METHODS: We prospectively collected microbiologic culture data on 83 adult patients undergoing orthotopic liver transplantation (OLT) using standard procedures and commercially available tests. Susceptibility of the strains to antibacterial agents was performed by the Clinical and Laboratory Standards Institute (CLSI) guidelines. RESULTS: All patients were followed prospectively for the first 4 weeks after surgery. Among 284 microbial isolates from clinical surgical site samples in 80 liver recipients, cultures were positive in 110 samples. The most commonly isolated species were: Gram-positive cocci (n = 222 isolates, 78%) with dominance of methicillin-resistant coagulase-negative staphylococci (MRCNS; 42%) and high-level aminoglycoside-resistant enterococci (HLAR strains; 24.3%). Gram-negative bacteria were identified in 21.5% of positive cultures, including 30 strains (24%) from the Enterobacteriaceae family, with 13.3% of extended spectrum beta-lactamase producers [ESBL(+)]. Significant differences (P = .0012) were observed during the analysis of changes in the occurrence of Gram-positive bacteria isolated from the surgical site in the first week versus the second to the end of the fourth week. CONCLUSION: Gram-positive bacteria predominated as 78% of isolates.

Bacteria isolated from bile samples of liver recipients in the early period after transplantation: epidemiology and susceptibility of the bacterial strains.

OBJECTIVE: We estimated the frequency and susceptibility to antibacterial agents of bacterial isolates from bile samples obtained from 83 liver recipients in the early period after transplantation. PATIENTS AND METHODS: We prospectively collected data on 83 adult patients undergoing orthotopic liver transplantation (OLT), including bile samples taken during the first 30 days after OLT from adult liver recipients suspected to have bile infections. The isolation/identification of cultured bacteria was performed according to standard microbiological procedures and commercially available tests. Susceptibility of the strains to antibacterial agents was determined according to the Clinical and Laboratory Standards Institute (CLSI) guidelines. RESULTS: Among 210 bile samples obtained from 79 liver recipients, bacterial cultures were positive in 110 samples from 59 (75%) recipients yielding 156 bacterial strains. The most commonly isolated species were as follows: gram-positive cocci (109 isolates) with dominance of coagulase-negative staphylococci (52%) and enterococci (36%); and gram-negative bacteria, 21 strains from the Enterobacteriaceae family and 14 of non-fermenting rods. We identified some multidrug-resistant (MDR) bacterial strains. In the first week after OLT, we investigated samples from 59 patients, yielding 36 bacterial strains. From the second to the end of the fourth week after OLT, 120 bacterial strains were isolated from 65 recipients. CONCLUSION: Gram-positive bacteria comprised 68.5%. The dominance of MDR gram-positive bacteria may be related to selection by perioperative antibiotic prophylaxis.

Detection of Clostridium difficile in stool samples from patients in the early period after liver transplantation.

OBJECTIVE: We examined the frequency of detection of Clostridium difficile (CD) toxins compared with the recovery of C. difficile in stool specimen cultures among orthotopic liver transplant (OLT) patients with nosocomial diarrhea in the early period. MATERIALS AND METHODS: The study included stool samples obtained during the first 30 days after OLT in adults who were suspected of CD-associated diseases. The identification of cultured CD strains was performed by standard microbiological methods. The presence of CD toxins was assayed using a commercial immunoassay. RESULTS: All patients were followed prospectively for CD infections from the date of OLT for the first 4 weeks after surgery. Among 54 samples, 16.7% were culture-positive for CD. CD toxins were tested on 54 samples, yielding 63% toxin-positive samples and 30% toxin- and culture-negative results. In the first week after OLT, samples from 19 patients were subjected to CD investigation. Among 19 samples positive for toxin, 52.6% of all samples were culture-negative. We analyzed 35 samples from the second to the fourth week after OLT in 31 recipients. Among 35 samples, 68.6% and 25.7% were positive for CD toxin and for culture, while 20% of samples were negative for toxin and culture. CONCLUSION: In our study, 63% of samples were toxin-positive with 16.7% yielding growth of CD and 30% being negative for toxins and cultures.

Etiological agents of bacteremia in the early period after liver transplantation.

Bacteremia is one of the major infections in orthotopic liver transplantation (OLT). The study of 83 adults who underwent OLT from 2001 to 2004, included patients followed prospectively from the day of transplantation to 4 weeks after the procedure by bacteriological cultures. The microorganisms were investigated according to standard National Committee for Clinical Laboratory Standards (NCCLS) procedures. Blood samples were examined in 59 recipients (71.1%) before and in 76 patients (91.6%) during the month after transplantation. Among 249 investigated samples, 96 were positive, as cultured from 19 recipients before OLT and 48 patients afterward. The most common were Gram-positive cocci (n = 71) and coagulase-negative staphylococci (n = 52), including methicillin-resistant coagulase-negative staphylococci (MRCNS). Enterococcus spp. occurred in 9 isolates (high-level aminoglycoside-resistant enterococci [HLAR] strains were cultured). We cultured the Enterobacteriaceae family (n = 16 isolates) and (n = 15 isolates), Gram-negative nonfermenting rods some of which were extended spectrum beta-lactamase producing [ESBL(+)] strains. The predominance of Gram-positive cocci was caused by CNS, and the use of prophylaxis to reduce Gram-negative bacteria. The increased rate of isolation of bacteria with multidrug resistance (MDR) to antimicrobial agents may be due to their frequent use for prophylaxis of bacterial infections in OLT. These MDR bacterial strains caused severe BSI after OLT.

Clinical glycopeptide-resistant enterococci isolated from patients after solid organ transplantation.

The aim of this study was to confirm the identification and resistance to vancomycin and teicoplanin of nosocomial enterococcal strains using molecular biology methods. Glycopeptide-resistant enterococci (GRE) strains were isolated from clinical specimens of hospitalized patients. Bacterial identification was performed in an automatic ATB Expression system (bioMérieux SA). Susceptibility to glycopeptides was determined by the disc diffusion method and Etest (AB BIODISK, Sweden). We performed polymerase chain reactions (PCR) for Enterococcus faecium and E. faecalis identification and van genes detection. Fifteen GRE strains were cultured over 2 years (2003-2004). Fourteen isolates were highly resistant to vancomycin (MIC range, 128->256 mg/L) and teicoplanin (MIC range, 32->256 mg/L). Twelve strains harbored van A gene (Van A phenotype). Seven isolates were identified as E. faecium and seven as E. faecalis by the multiplex-PCR method. One strain-E. casseliflavus-showed low resistance to vancomycin (MIC 8 mg/L) with retained susceptibility to teicoplanin (MIC 4 mg/L). It harbored the van C2/C3 gene and was identified as the Van C2/C3 phenotype. GRE strains were more often isolated from hospitalized patients in Poland. Constant monitoring by reliable microbiological methods has become necessary to prevent the spread of these strains in the hospital environment.

Mixed bloodstream infection with Staphylococcus aureus and Penicillium chrysogenum in an immunocompromised patient: case report and review of the literature.

We report a case of an immunocompromised patient who developed a mixed bacterial-fungal bloodstream infection involving Staphylococcus aureus and Penicillium chrysogenum. To date, no reports of such mixed bloodstream infection have been found.

Epidemiology of clinical isolates of Candida albicans and their susceptibility to triazoles.

The study comprised strains of Candida albicans isolated from patients hospitalised in a tertiary care hospital during a 2-year period. In total 851 strains were cultured, including 379 (44.5%) strains from internal medicine patients, 243 (28.6%) from surgical patients and 229 (26.9%) from patients in the surgical intensive care unit. The strains were tested for susceptibility to the triazoles: fluconazole and itraconazole. There were 523 (61.5%) strains susceptible, 11 strains (1.3%) showed intermediate susceptibility and 317 (37.2%) were resistant to fluconazole, while 403 (47.3%) strains were susceptible, 43 (5.1%) intermediately susceptible and 405 (47.6%) resistant to itraconazole. Regular surveillance of fungal resistance patterns should be carried out and there should be prudent use of hospital triazole usage.

Adhesion molecule expression stimulated by Bacteroides thetaiotaomicron cell-surface antigens.

Bacteroides thetaiotaomicron, a Gram-negative anaerobic rod belonging to the Bacteroides fragilis group (BFG), is involved in many systemic and local, most frequently suppurative infections in man. The cell envelope of these rods is composed of two carbohydrate-containing antigens: lipopolysaccharide (LPS) and capsular polysaccharide (CPS). Adhesion molecules ICAM-1, VCAM-1 and E-selectin (ELAM-1) are induced on the endothelial cells by mediators of inflammation. The aim of this study was to assay the ability of B. thetaiotaomicron surface antigens to induce adhesion molecule expression on the endothelial cells. The influence of LPS and CPS on the expression of adhesion molecules on HMEC-1 cell line was examined in an ELISA test. ELISA was performed with monoclonal mouse anti-human: ICAM-1, VCAM-1 and E-selectin antibodies of the IgG class. B. thetaiotaomicron lipopolysaccharides revealed the ability to induce ICAM-1, VCAM-1 and E-selectin expression on the endothelial cells. Their activities were similar, but lower than the activity of Eschericha coli LPS. ICAM-1 was the most stimulated adhesion molecule. The strongest activation by LPS was achieved at the concentrations of 10.0 and 1.0 micrograms/ml. The ability of capsular polysaccharide to induce the expression of adhesion molecules was considerably weaker.

[Selected properties of Bacteroides fragilis enterotoxigenic strains]. / Wybrane cechy enterotoksynotwórczych szczepów Bacteroides fragilis.

Seven B. fragilis strains were examined. One strain was reference, non-enterotoxigenic, representing serotype E2 according to Beerens et al. (1971). Six strains produced enterotoxin (ETBF). Four of them were isolated from human feces and two of them from swine feces. All strains were investigated morphologically, biochemically (ATB Expression, France) and by means of direct immunofluorescence (Bacteroides--IF test, Poland). Their resistance to chemotherapeutics was tested (ATB Expression, France). The MIC values of clindamycin and metronidazole were determined using E test strips (AB Biodisk, Sweden). Each strain formed capsules. The percentage of encapsulated cells was high (80-100%). Some strains produced thick capsules. Biochemical patterns were similar and typical for B. fragilis rods. One enterotoxigenic strain produced gelatinase and three ETBF strains fermented trehalose. All strains reacted in direct immunofluorescence exclusively with conjugate against serotype E of BFG. Thus, each strain showed antigenic pattern E. Drug susceptibility of all strains was similar. One enterotoxigenic strain was resistant to clindamycin. All strains were susceptible to metronidazole. These studies indicate that on the basis of morphological, biochemical and serological features (IF), enterotoxigenic B. fragilis strains cannot be distinguished from the nonenterotoxigenic one. Also, the correlation between toxigenicity and drug sensitivity of the examined strains is not observed.

[Use of cell-surface antigens of Bacteroides thetaiotaomicron in the passive hemagglutination test and in the inhibition of passive hemagglutination]. / Zastosowanie powierzchniowych antygenów Bacteroides thetaiotaomicron w odczynach hemaglutynacji biernej i zahamowania hemaglutynacji biernej.

The antigens were prepared from three B. thetaiotaomicron strains of different origin (NCTC 10582--reference strain, 312/85--isolated from a pancreas fistula drain of a patient, and 9/18--derived from normal human intestinal microflora). Lipopolysaccharides were extracted by the hot phenol-water method and purified by nuclease tretment. Degradation of lipopolysaccharides was achieved by mild acid hydrolysis obtaining polysaccharide (PS) and lipid (LA) fractions. Capsular polysaccharide (CPS) was extracted from the clinical strain 312/85 producing thick capsules. Antibacterial sera were prepared by immunization of rabbits with formolized suspensions of investigated strains. HA and IHA were performed with all antigens and immune sera. Examined cell-surface antigens (LPSs and CPS) were capable of coating formolized sheep erythrocytes. The titres obtained in the passive hemagglutination test in homologous reactions were 160-320. Polysaccharide fractions (PS) prepared by means of mild acid hydrolysis of LPSs were unable to coat formolized sheep red blood cells. The activity of sensitization of sheep erythrocytes was revealed by lipid fractions of LPSs. All preparations were active as inhibitors in the inhibition of passive hemagglutination. The strongest inhibitors in homologous systems were polysaccharide fractions of LPSs and capsular polysaccharide (the concentration of inhuibitor 8-15 micrograms/ml). The results of performed serological tests indicated the antigenic similarity of standard B. thetaiotaomicron strain NCTC 10582 and clinical strain 312/85. The strain 9/18 from normal human intestinal microflora showed distinct antigenicity. High-molecular cell-surface B. thetaiotaomicron antigens containing carbohydrates (LPS and CPS) can be applied in the passive hemagglutination test and in the inhibition of passive hemagglutination.

[Occurrence of extended spectrum beta-lactamases (ESBL) and inducible beta-lactamases (IBL) in clinical strains of gram-negative rods]. / Wystepowanie beta-laktamaz o rozszerzonym spektrum substratowym (ESBL) i beta-laktamaz indukowanych (IBL) u klinicznych szczepów paleczek Gram-ujemnych.

This study was undertaken to check the situation concerning the occurrence of Gram-negative rods producing extended-spectrum beta-lactamases (ESBL) and inducible beta-lactamases (IBL) in clinical specimens from patients hospitalized in National Clinical Hospital No. 1 in Warsaw. Such determinations were not performed in this hospital so far. During three months (April-June, 1997) 200 strains of Gram-negative rods were cultured. The strains were identified in automatic ATB system using strips with biochemical tests: ID 32 E for enteric rods and ID 32 GN for non-fermenting rods. ESBL-producing strains were detected with double disc diffusion test according to Jarlier et al. (1988). Clavulanate was applied as the inhibitor of beta-lactamases (AMO/CLAV disc). Inducible beta-lactamases were determined using double disc method according to Sanders and Sanders (1979). Cefoxitin was the inductor of these beta-lactamases. 82 strains (41% of all strains) belonging to Enterobacteriaceae family, 92 strains (46%) of Pseudomonadaceae rods and 26 strains (13%) of other Gram-negative rods were isolated. 30 ESBL-producing strains (15% of all strains) and 45 strains (22.5%) with IBL activity were detected. The obtained results confirm the necessity of continuous and reliable monitoring of ESBL--and IBL--producing strains among Gram-negative rods isolated from clinical materials. The aims of such procedure are the control and prevention of their dissemination within a hospital as well as the avoidance of therapeutic failures.

[Susceptibility of clinical strains of gram-positive bacteria to selected beta-lactam antibiotics]. / Wrazliwosc klinicznych szczepów bakterii gram-dodatnich na wybrane antybiotyki beta-laktamowe.

The aim of the study was to determine the activity of four beta-lactam antibiotics against nosocomial strains of Gram-positive bacteria. Two antibiotics combined with beta-lactamase inhibitors: timentin (TIC/CLAV) and tazocin (PIP/TZB) and two carbapenems: imipenem and meropenem were applied. The clinical strains were isolated from patients hospitalized in surgical ward of the National Clinical Hospital No 1 in Warsaw. The strains were identified in the automatic ATB system using ID 32 STAPH, API STREP, API CORYNE and API 20 A strips. The susceptibility of isolates to antibacterial agents was determined in the automatic ATB system using ATB STAPH, ATB STREP and ATB ANA strips. The susceptibility of strains to timentin, tazocin, imipenem and meropenem was tested with disc diffusion method. 111 strains of Gram-positive bacteria were cultured. Staphylococci (49) and enterococci (44) dominated among isolated strains. 33 Staphylococcus spp. strains were identified as methicillin-resistant. The obtained results indicate a significant role of Gram-positive cocci (staphylococci and enterococci) in the aetiology of nosocomial infections. Antibiotics combined with beta-lactamase inhibitors and carbapenems demonstrate broad antibacterial spectrum against clinical strains of Gram-positive bacteria except E. faecium strains.

[Effect of suprainhibitory (supra-MIC) concentration of clindamycin on endotoxin release from Bacteroides fragilis]. / Wplyw nadprogowego (supra-MIC) stezenia klindamycyny na uwalnianie endotoksyny przez Bacteroides fragilis.

The aim of this work was to determine the influence of clindamycin at concentration 100 x MIC on the growth of culture and the induction of endotoxin release from the cells of standard B. fragilis IPL E 323 strain. The antibiotic was added to 24-hour culture of the strain in BHI medium (time 0), its final concentration was 12.5 mg/l. The samples for further examinations were collected at time 0 and after 1, 2, 3 and 24 hours of continued incubation. At the same time the strain was cultured in a medium without the antibiotic. The optical density (OD 420 nm) of each sample was determined, they were centrifuged (2000 x g, 10 min), the supernatants were filtered (0.45 micron filters) and concentrated three times (5000 D ultrafilters). Two serological methods were applied to detect the presence of endotoxin in filtrates of culture medium: immunoelectroprecipitation (IEP) and immunoenzymatic assay (dot-ELISA) with rabbit anti-IPL E 323 immune serum. The results of experiments performed with filtrates of culture without the antibiotic indicate that standard B. fragilis IPL E 323 strain liberates endotoxin spontaneously to the culture medium. Single suprainhibitory dose of clindamycin at concentration 100 x MIC inhibits the growth of examined strain and does not cause augmented release of endotoxin from B. fragilis cells in vitro.

[Susceptibility of clinical strains of gram-negative rods to selected beta-lactam antibiotics]. / Wrazliwosc klinicznych szczepów paleczek gram-ujemnych na wybrane antybiotyki beta-laktamowe.

The aim of the study was to determine the activity of four beta-lactam antibiotics against nosocomial strains of gram-negative bacilli. Two antibiotics combined with beta-lactamase inhibitors: timentin (TIC/CLAV) and tazocin (PIP/TZB) and two carbapenems: imipenem and meropenem were applied. The clinical strains were isolated from patients hospitalized in the following wards: surgery and intensive care unit of State Clinical Hospital No 1 in Warsaw. The strains were identified in the automatic ATB system using ID 32 E and ID 32 GN strips. The susceptibility of isolates to antibacterial agents was determined in the automatic ATB system using ATB G- and ATB PSE strips. The susceptibility of the strains to imipenem, meropenem, timentin and tazocin was tested by disc-diffusion method. 157 strains of gram-negative bacilli were cultured. 100 strains were isolated from patients hospitalized in surgical ward and 57 strains from patients hospitalized in ICU. Nonfermenting rods dominated among isolated strains-91. The results obtained indicate that multiresistant gram-negative rods causing serious therapeutic problems are often isolated from clinical specimens. The contribution of nonfermenting rods, especially Pseudomonas spp. and Acinetobacter spp. to the etiology of infections in hospitalized patients has increased. Infections caused by these strains are difficult to cure. Tazocin and carbapenems (imipenem and meropenem) are highly active in vitro against the examined strains of gram-negative bacilli.

[Comparison of several methods for detection of methicillin resistance in clinical strains of Staphylococcus sp]. / Porównanie kilku metod oznaczania opornosci na metycyline klinicznych szczepów Staphylococcus sp.

108 Staphylococcus spp. strains from 300 clinical specimens from hospitalized patients were isolated. Identification and drug resistance were determined using automated ATB system. 37 S. aureus strains, 44 S. epidermides strains and 27 strains of other coagulase-negative staphylococci were cultured. Sensitivity to methicillin of S. aureus was determined with four methods: ATB system, disc-diffusion (Oxa 1 microgram), Crystal MRSA ID System and agar screen test in TSA medium with methicillin (25 micrograms/ml). 13 S. aureus strains (about 1/3 of strains) were methicillin-resistant (MRSA). Complete conformity of the results was obtained with Crystal MRSA ID, disc-diffusion and agar screen tests. In the case of three S. aureus strains the results of determination in ATB system were not consistent with the results obtained with the use of the methods mentioned above. Susceptibility to methicillin of 71 coagulase-negative strains (CNS) was determined using two methods at first: ATB and disc-diffusion. In the case of 25 methicillin-resistant strains identical results were obtained. For 20 coagulase-negative strains non-conformity with the results of these two methods was observed. As the decisive method, the agar screen test (TSA-MET) was applied. 18 of these 20 CNS strains were categorized as methicillin-resistant. Finally, 43 MRCNS (i.e. 60%) were detected among 71 coagulase-negative strains. The results of methicillin resistance determination of staphylococci in an automated system should be confirmed with a second test such as agar screen, disc-diffusion or Crystal MRSA ID System (in the case of S. aureus).

[Drug resistance in nosocomial strains of staphylococci to methicillin]. / Lekowrazliwosc szpitalnych szczepów gronkowców metycylinoopornych.

The aim of the present study was the analysis of drug susceptibility of MRSA and MRCNS strains isolated from patients hospitalized in 14 wards of the State Clinical Hospital No 1 in Warsaw. The strains were identified (ID 32 STAPH), and their susceptibility to antimicrobial agents (ATB STAPH) was determined in ATB system (bioMérieux, France). Four methods were applied to confirm the resistance to methicillin: ATB-plus system, disc-diffusion method (Oxa 1 microgram, Oxoid, U.K.), Crystal MRSA ID (Becton Dickinson-BBL, USA) and agar screen test in TSA medium (Difco, USA) with methicillin (25 mg/l, Sigma, USA). 108 Staphylococcus spp. strains were found in 300 clinical specimens. 56 strains were methicillin-resistant (52%). Among methicillin-resistant strains 13 MRSA, 28 MRSE and 15 of other species were found. All MRSA strains were susceptible to vancomycin, teicoplanin and fusidic acid. MRCNS were susceptible first of all to vancomycin (43/43), minocycline (42/43) and pristinamycin (42/43). On the basis of the obtained results it can be stated that methicillin-resistant staphylococci occur in hospital wards. The greatest number of methicillin-resistant strains was cultured from patients hospitalized in surgery wards (32), methicillin-resistant strains much more frequently occur among coagulase-negative staphylococci, especially in Staphylococcus epidermis. Glycopeptide antibiotics are most active against isolated MRSA strains. The most active therapeutic agent against MRCNS is vancomycin.

[Drug resistance of 100 clinical strains of Enterococcus spp]. / Lekowrazliwosc 100 klinicznych szczepów Enterococcus spp.

The aim of this study was to evaluate the drug susceptibility of 100 Enterococcus spp. strains isolated from patients hospitalized in State Clinical Hospital No 1 in Warsaw. All strains were identified (API 20 STREP) and their susceptibility to antibiotics was tested (ATB STREP) in automatic ATB system. Additionally, PYRase activity, beta-lactamase production (in nitrocefin test), MICs for vancomycin and teicoplanin (E test), HLAR--high level aminoglycoside resistance and susceptibility to vancomycin, teicoplanin, piperacillin and piperacillin/tazobactam (disc diffusion method) were determined. E. faecalis ATCC 29212 was used as the control strain. Fifty E. faecalis, 45 E. faecium, 2 E. casseliflavus, 2 E. durans and 1 E. avium strain were cultured. All strains were PYRase-positive and beta-lactamase-negative. Ten isolates demonstrated intermediate susceptibility to vancomycin (6--E. faecalis and 4--E. faecium). One E. faecalis strain was intermediately susceptible to both glycopeptides. One E. casseliflavus strain showed low-level resistance to vancomycin, but this strain was susceptible to teicoplanin--phenotype Van C. HLAR strains were found among 31 E. faecalis and 40 E. faecium strains. 48 E. faecalis strains were susceptible to piperacillin and 49 to piperacillin/tazobactam. Whereas, 41 E. faecium were resistant to both these drugs. Thirty six per cent of isolates were resistant to penicillin and ampicillin, 73% to erythromycin, 87% to tetracycline, 89% to lincomycin and 56% to nitrofurantoin. Some discrepancies were noticed between the results of different methods applied for susceptibility testing--ATB system, E test and disc diffusion. These discrepancies concerned HLAR detection and susceptibility to glycopeptides determination. The best methods were: disc-diffusion for HLAR detection and E test for determination of resistance to vancomycin and teicoplanin. Increasing resistance to antimicrobial agents is observed in clinical Enterococcus spp. isolates cultured in our laboratory, especially in E. faecium strains. It is necessary to control the dissemination of multiresistant Enterococcus spp. strains in hospital wards.

[Production of enterotoxins by Bacteroids fragilis strains--effect of clindamycin]. / Wytwarzanie enterotoksyny przez szczepy Bacteroides fragilis--wplyw klindamycyny.

Four B. fragilis strains were examined: one nonenterotoxigenic (NTBF) and three producing enterotoxin (ETBF). The growth of cultures was determined and enterotoxin, which is released to the culture medium during growth of strains, was detected. BHI broth and BHI broth with addition of subinhibitory doses (sub-MIC) of clindamycin were applied. Bacterial cultures were incubated at 37 degrees C for 48 hours. After 4, 8, 16, 24, 48 hours of cultivation, samples of bacterial cultures were collected and the optical density was measured. Then the samples were centrifuged, supernatants were filtered through 0.45 micron filters and concentrated three times with 5000 D ultrafilters. Prepared samples were kept frozen at -70 degrees C until used. The titre of enterotoxin in samples was determined on human colon adenocarcinoma cell line HT 29/C1. Neutralization assay was performed with culture filtrates, which were enterotoxin-positive and with rabbit anti-enterotoxin serum. The results of the experiments indicate that enterotoxin is detected after 16 hours of incubation of ETBF strains. Clindamycin at subinhibitory concentrations (sub-MIC) inhibits the growth of B. fragilis cultures. The antibiotic causes also delay and decrease in enterotoxin production by ETBF strains.

[Stimulation of adhesion molecules on vascular endothelium by capsular polysaccharide, lipopolysaccharide and components of lipopolysaccharide from Bacteroides thetaiotaomicron]. / Stymulacja czasteczek adhezyjnych sródblonka naczyniowego przez polisacharyd otoczkowy, lipopolisacharyd oraz komponenty lipopolisacharydu Bacteroides thetaiotaomicron.

The aim of this study was to assay the influence of capsular polysaccharide (CPS), lipopolysaccharide (LPS) and components of B. thetaiotaomicron lipopolysaccharide--polysaccharide part (PS) and lipid part (lipid A) on the expression of adhesion molecules associated with inflammation (ICAM-1, VCAM-1, E-selectin) on the surface of vascular endothelial cells. Capsular polysaccharide was isolated by the method of Poxton and Ip (1981). Lipopolysaccharides were extracted using the hot phenol-water method (Westphal and Jann, 1965). Components of LPS were prepared by mild acid hydrolysis of lipopolysaccharide. Experiments with bacterial compounds at concentrations 10, 1, 0.1 and 0.01 (mg/ml) were performed on HMEC-1 cell line (human dermal microvascular endothelial cells). Immunoenzymatic ELISA test with mouse monoclonal antibodies against human: ICAM-1, VCAM-1 and E-selectin was applied to determine adhesion molecules. Resting HMEC-1 and E. coli O55:B5 LPS were used as controls in each experiment. Lipopolysaccharides were the strongest stimulants of endothelial adhesion molecules. Capsular polysaccharide caused the expression of three adhesion molecules, but only at the highest concentration (10 mg/ml). The stimulatory activities of LPS lipid components were much higher than the activities of polysaccharide parts. PS preparations did not reveal the property of adhesion molecule stimulation or their activities were weak. The activity of B. thetaiotaomicron cell-surface antigens in the process of adhesion molecule stimulation on vascular endothelium was lower than the activity of E. coli LPS.

[Adhesion of human T lymphocytes and granulocytes to endothelial cells stimulated by cell-surface antigens of Bacteroides thetaiotaomicron]. / Adhezja ludzkich limfocytów T i granulocytów do komórek sródblonka naczyniowego stymulowanych powierzchniowymi antygenami Bacteroides thetaiotaomicron.

The aim of this study was to assay the degree of human T lymphocyte and granulocyte adhesion to the vascular endothelial cells stimulated by Bacteroides thetaiotaomicron lipopolysaccharides, components of LPS and capsular polysaccharide. HMEC-1 cells were activated with bacterial preparations in concentration 10 micrograms/ml for 4 and 24 hours. T lymphocytes and granulocytes were isolated from peripheral blood of healthy blood donors. Thereafter, the adhesion tests of granulocytes and adhesion tests of non-activated and activated with PMA (in concentration 10 ng/ml) T lymphocytes to the resting and stimulated vascular endothelium were performed. The number of viable cells, which adhered to the endothelium, was determined using inverted microscope (magnification 200x). The results were presented as the number of viable cells adhering to 1 mm2 of the endothelial cell culture. The obtained results indicate that granulocytes and T lymphocytes (resting and activated with PMA) adhere to the endothelial cells stimulated by B. thetaiotaomicron cell-surface antigens. B. thetaiotaomicron lipopolysaccharides and capsular polysaccharide are weaker stimulants of human leukocyte adhesion to the HMEC-1 cells than E. coli O55:B5 LPS.