Strongyloides-infected patients at Charleston area medical center, West Virginia, 1997-1998.

Twenty Strongyloides-infected patients were diagnosed at West Virginia's Charleston Area Medical Center in 1997 and 1998. We recommend that strongyloidiasis, which can be fatal, be a reportable disease in West Virginia.

Beta-lactamase-positive strains of Haemophilus influenzae: susceptibility to and inactivation of beta-lactam antibiotics.

Susceptibility and time-kill studies were done with low and high inocula of both beta-lactamase-positive and -negative strains of Haemophilus influenzae with cefamandole, ampicillin, cefoperazone, mezlocillin, moxalactam, and ceftriaxone. Bioassay was done to test for antibiotic inactivation by beta-lactamase-positive strains. All six antibiotics were highly active against the low inoculum (10(4) to 10(5) colony-forming units/ml) of beta-lactamase-negative strains; ceftriaxone, moxalactam, and cefoperazone were equally active against the same inoculum concentration of beta-lactamase-positive strains. In contrast, cefamandole, mezlocillin, and ampicillin were less active against the low inoculum of beta-lactamase-positive H influenzae. A marked inoculum effect occurred with the high inoculum (10(7) to 10(8) CFU/ml) with all six antibiotics, regardless of beta-lactamase production. In time-kill studies, marked differences in bacterial killing resulted after low and high inocula. Ampicillin, cefamandole, cefoperazone, and mezlocillin were rapidly inactivated by the high inoculum of beta-lactamase-positive H influenzae.

The potential value of endotoxin-amylase detection in peritoneal lavage fluid.

Widespread acceptance of Limulus Amoebocyte Lysate testing in clinical situations has been elusive. The results obtained in this series of 38 patients seem to support the contention that the amylase-endotoxin complex can be of value in detecting rapidly and with reasonable sensitivity the presence of pancreatic injury and gastrointestinal perforations. A corrected WBC count appears to add diagnostic possibilities to the technique. Despite the promising evidence detailed in this paper, further studies are required to establish the true sensitivity/specificity of the test. Its validity and utility could be assessed rapidly if traumatologists who routinely perform lavage would utilize this method and report their findings.

A rapid paper-disc test for penicillinase.

A practical acidimetric assay for penicillinase production using penicillin and phenol red impregnated in paper discs was developed. Blank discs were first impregnated with buffered penicillin G and, after drying, with 1% phenol red. For use, a disc was added to a bacterial suspension made in saline solution. A yellow color within 1 to 30 min of incubation indicated penicillinase production. These discs were tested against Staphylococcus aureus, Haemophilus influenzae, and Neisseria gonorrhoeae, and the assay was found to be a simple, rapid, and accurate method for detection of penicillinase.

Hemophilus influenzae pneumonia in adults: report of five cases caused by ampicillin-resistant strains.

Recently there has been increased recognition of Hemophilus influenzae as a cause of pneumonia in adults. Although ampicillin-resistant strains of Hemophilus influenzae have been a major problem in pediatric practice, such strains have not previously been noted to be a significant problem in the treatment of adult pneumonia. We report 5 cases of pneumonia caused by beta-lactamase-producing strains of Hemophilus influenzae. These organisms were susceptible to chloramphenicol but resistant to ampicillin. Cure was achieved by treatment with chloramphenicol after the initial treatment with ampicillin had failed. The ability of a microbiology laboratory to isolate and to test routinely for ampicillin-resistant strains is an important factor in the successful treatment of Hemophilus influenzae infections.

Kinetics of cellular and humoral response of rabbits immunized with mycoplasma pneumoniae.

The cellular and humoral responses of rabbits immunized with Mycoplasms pneumoniae antigen in saline or incorporated in Freund's complete adjuvant were examined. Peripheral blood leukocytes were used for the leukocyte migration inhibition (LMI) test. Both groups of animals showed significant LMI activity in the presence of M. pneumoniae as well as cross-reacting M. salivarium antigens but response to M. pneumoniae antigen was more pronounced. In the humoral response no such cross-reactivity was observed. Although some of the animals (3/8) demonstrated antibodies to M. salivarium prior to immunization the titers were not influenced by the immunization with M. pneumoniae antigen. Both groups of animals produced antibodies to M. pneumoniae antigen only, but significantly higher titers were observed in the adjuvant group. Cold hemagglutinins in both groups appeared earlier than the specific antibodies to mycoplasma. The adjuvant had no effect on the production of the cold agglutinins.

Isolation and characterization of a catalase-negative strain of Staphylococcus aureus.

An unusual, naturally occurring strain of Staphylococcus aureus is characterized. It is typical in colony and cellular morphology, coagulase production, and other biochemical reactions as compared to S. aureus (ATCC-25923), except that it is catalase negative and fails to ferment mannitol anaerobically.