Extended-spectrum beta-lactamase-conferring transferable resistance to different antimicrobial agents in Enterobacteriaceae isolated from bloodstream infections.

Twenty (18.5%) out of 108 clinical isolates of the family Enterobacteriaceae responsible for bloodstream infection were extended-spectrum beta-lactamase (ESBL)-positive in two screening tests, the double disk synergy test and the Oxoid Combination Disk method. Eleven out of the 20 ESBL-positive isolates transferred oxyimino-beta-lactam resistance to E. coli K12 C600 recipient strain with a frequency of 10(-8) - 10(-1) per donor cell. PCR analysis revealed that the majority of the transconjugants (9 of 11) express CTX-M-type beta-lactamases. Donor strains and their transconjugants displayed susceptibility patterns typical of ESBL producers. They were resistant to oxyimino-beta-lactams but susceptible to clavulanic acid and carbapenems. Resistances to aminoglycosides, tetracycline and mercuric chloride were, in some cases, co-transferred with oxyimino-beta-lactam resistance, suggesting that various resistance determinants were carried by the same conjugative plasmids.

Boranophosphate nucleic acids--a versatile DNA backbone.

Important chemical and biochemical properties of boranophosphate DNA and RNA oligonucleotides are reviewed. Stereoregular boranophosphate oligomers can be synthesized enzymatically and form stable duplexes with DNA. Fully boronated, non-stereoregular oligothymidylates, synthesized chemically, form hybrids with poly(A) that have lower melting points than oligothymidylate:poly(A), yet they nevertheless can support the RNase H mediated cleavage of RNA.

The mechanism of bactericidal action of normal human serum against Salmonella rods.

Forty Salmonella strains sensitive to the bactericidal action of serum were investigated. All these strains were susceptible to complement activated by the classical pathway though in part (60%) of these strains the presence of lysozyme was necessary for killing. S. typhimurium rods were susceptible to only one mechanism of the action of bactericidal factors. On the contrary, S. enteritidis strains were sensitive to three various mechanisms of bactericidal action of serum. Next eight forms of Salmonella typhimurium LT2 differing with respect to the structure of LPS were studied. Original strain was a smooth, form S, and remaining strains were various rough (R) forms such as Ra, Rb1, Rb2, Rc, Rd1, Rd2, Re. The S form was susceptible only to the complete human serum what means that all bactericidal factors of serum were needed for killing. Ra form was susceptible to two independent bactericidal mechanisms: complement (C) activated by the alternative pathway in the presence of lysozyme and C activated simultaneously by both bactericidal C pathways without the participation of lysozyme (al, ac). The next form, Rb1, besides the mechanism mentioned above was also susceptible to C activated by the classical pathway in the presence of lysozyme (al, ac, cl). Other forms (Rb2, Rc, Rd1, Rd2, Re) were susceptible to three mechanisms (al, ac, cl) as well as to C activated by the classical pathway without lysozyme (c). The mechanism (c) was weakly efficient against forms Rb2 and Rc and somewhat more efficient against Rd1 and Rd2 and the most efficient against Re.

Bactericidal activity of normal human serum against Morganella, Proteus, and Providencia strains.

The susceptibility od Proteus, Providencia, and Morganella strains to bactericidal action of human serum was examined. The percentage of survival was determined after one and three hours incubation with 50% human serum. The susceptible strains were treated by serum preparations with blocked classical or alternative complement activation pathways as well as with lysozyme removed. Following mechanisms of the bactericidal action of serum were found: complement activated by the classical or alternative pathway with participation of lysozyme, complement activated simultaneously via both pathways-while the participation of lysozyme was necessary for killing some strains and superfluos for others and complement activated only via the classical pathway without lysozyme.

[Selected parameters of blood coagulation and fibrinolysis and their relationship to the level of diabetes control in patients with insulin-dependent diabetes mellitus]. / Wybrane parametry ukadu krzepniecia i fibrynolizy oraz ocena ich zaleznosci od stopnia wyrównania cukrzycy u chorych na cukrzyce insulinozalezna.

The aim of the study was to evaluate plasma concentration of fibrinogen, plasma activity of antithrombin III (AT-III) and plasma activity of plasminogen activator inhibitor (PAI-I) in insulin-dependent diabetic (IDDM) patients and the assessment of correlation between them and the parameters of glyco-metabolic control comprising glycemia and concentrations of fructosamine and glycated hemoglobin HbA1c. Eighteen IDDM patients (mean age 28.3 +/- 11.3 ys, mean duration of disease 12.2 +/- 5.3 ys) without over nephropathy and without macroangiopathy were investigated. Control group consisted of 8 healthy subjects. Plasma fibrinogen concentrations were similar in IDDM patients and in controls (3.54 +/- 0.45 g/l and 3.31 +/- 0.54 g/l respectively). Plasma activity of AT-III in diabetic patients (90.6 +/- 22.4%) was similar to that in healthy subjects (94.6 +/- 25.0%). Fibrinogen concentrations and AT-III activities showed no correlation with glycemia and concentrations of fructosamine and HbA1c. Plasma activity of PAI-I was significantly lower in diabetics than in controls (respectively 1.56 +/- 0.72 U/ml and 2.75 +/- 1.25 U/ml, p < 0.005). PAI-I activity correlated negatively with fasting blood glucose (p < 0.05) but did not correlate with concentrations of fructosamine or HbA1c. The results suggest that glycemic control in diabetic patients do not influence on concentrations of fibrinogen and activity of AT-III but diminished activity of PAI-I is related to hyperglycemia.

[Susceptibility of Proteus, Morganella and Providencia strains isolated from patients with urinary tract infections on bactericidal activity of normal human serum]. / Podatnosc szczepów Proteus, Morganella i Providencia izolowanych od chorych z zakazeniami ukladu moczowego na bakteriobójcze dzialanie normalnej surowicy ludzkiej.

Usefulness of the test determining bactericidal activity of normal human serum was investigated with 50 strains of Proteus, Morganella and Providencia isolated from patients with urinary tract infections (UTI) and with 50 strains isolated from feces. It was found that strains from UTI were more frequently resistant to the action of normal human serum (50% resistant) in comparison with strains isolated from feces (30% resistant). Strains of Proteus belonging to four species were differing greatly in their susceptibility to normal human serum. They can be ranked as followings: P. mirabilis (49% of resistant strains), P. vulgaris (62%), P. morganii (72%) and P. rettgeri (100%). In studies on interaction subinhibitory concentrations of cefotaxime and normal human serum in bactericidal reaction, a synergism was found only with some strains.

Iodized salt consumption, urinary iodine concentration and prevalence of goiter in children from four districts of north-western Poland (Szczecin coordinating center).

The study was aimed at evaluation of iodized salt consumption, urinary iodine concentration and incidence of goiter in children from four districts of north-western Poland: Szczecin, Koszalin, Slupsk and Gorzów Wlkp. The study was a part of the national programme: "Investigations of iodine deficite and iodine prophylaxis in Poland". The investigations were performed in ten schools randomly selected by Coordinating Centre in Kraków. Altogether 1793 children attending these schools (838 boys and 955 girls) of age between 6 ad 13 years, living in the cities and villages of coastal and lowland region were studied. The examination included interview in the form of a standard questionnaire, physical examination of the thyroid according to the WHO criteria, ultrasonographic evaluation of thyroid volume and determination of iodine concentration in single urine specimen. It appeared that only 11.2% of children used to consume iodized salt. Mean iodine concentration in urine was 76.2 micrograms/l both in children consuming and not consuming iodized salt, indicating dietary iodine deficiency. The incidence of goiter in country population of children (12.9%), indicated that the region of north-western Poland should be considered as an area of mild goiter endemy. These results suggest a need for iodine supplementation of edible salt in this region of Poland.

[Effectiveness of iodine prophylaxis and frequency of thyroid enlargement (thyroid goiter) and clinical diagnosis of thyroid diseases in inhabitants of the Szczecin region after the Czernobyl accident]. / Efektywnosc profilaktyki jodowej oraz czestosc wystepowania powiekszenia tarczycy (wola) i klinicznego rozpoznania chorób tarczycy u mieszkanców regionu szczecinskiego po awarii elektrowni atomowej w Czarnobylu.

The study, supported by program MZ-XVII, was carried on 4567 inhabitants of the area of Szczecin (2350 females and 2217 males). The population was chosen randomly, according to a simple drawing scheme. All subjects were clinically examined using standardised questionnaires. In 3468 persons (including 1807 girls and women, 1661 boys and men) apart form clinical examination, the assessment of thyrotropin, thyroxine and triiodothyronine in serum and frequency of antithyroglobulin antibodies and antithyroid membrane antibodies were evaluated. The data indicate that 94% of children in Szczecin's region received the prophylactic dose of iodine, mostly between the 1st and the 5th of May 1986. Only 17% of the adults received iodine. The most common preparation was Lugol solution given in a single dose. Among all persons who received iodine, only in 5% of subjects the side effects were noted (mostly in children), including symptoms of gastrointestinal tract (vomiting, abdomen pain) and occasionally intrathyroid side effects (thyroid pains). In examined population the high frequency of thyroid enlargement, mainly in women (up to 43-44% at the age group 30-50 years) was found. The frequency of clinical diagnosis of thyroid disease was higher in women than in man (most often the diffuse goiter, rarely the nodular goiter). The frequency of thyroid enlargement and clinical diagnosis of thyroid disease was not dependent on prophylactic iodine intake. The iodine prophylaxis did not influence on thyroid hormones and TSH serum levels and on frequency of antithyroid antibodies.