Molecular epidemiology of an outbreak of Enterobacter cloacae in the neonatal intensive care unit of a provincial hospital in Gauteng, South Africa.

An outbreak of Enterobacter cloacae in the neonatal intensive care unit of a provincial hospital in Gauteng, South Africa, resulting in nine deaths was investigated. Macrorestriction analysis using pulsed-field gel electrophoresis revealed that three isolates of E. cloacae from blood cultures of patients, six from environmental sources, and one from the hands of a staff member belonged to the same genotypic cluster.

The effect of kallikrein on spermatozoal ATP and other semen parameters.

Kallikrein promotes the release of kinins, which have been shown in in vitro studies to improve motility, viability and metabolism in human spermatozoa. The effects of kallikrein therapy on 25 males attending an infertility clinic was assessed, regarding endogenous spermatozoal ATP content, as well as other semen parameters. Thirteen of the 25 patients showed an improvement in either count, morphology, motility, viability, or a combination of these, after 3 months Kallikrein therapy. ATP levels in responders dropped by 58.8% (p less than 0.001). In nonresponders ATP levels did not change significantly. This indicates that improvement in spermatozoal parameters corresponds with increased ATP consumption, following Kallikrein therapy.

Adenosine triphosphate levels in human spermatozoa.

ATP levels in human spermatozoa have been positively correlated with good motility. This has given rise to the impression that good ATP levels per se are related to good motility, i.e., the higher the ATP level, the better the motility and fertilizing potential. There was no direct correlation between motility percentage, forward progression, viability percentage, and ATP levels (when expressed per 1 million spermatozoa) in the general population. This finding was not unexpected since other factors, such as defects of the microtubules and viscosity of the semen, could affect the motility in some patients. However, when semen from individual patients was assessed, the motility percent, viability, and ATP concentration decreased by comparable levels over a 4-h period postejaculation. Semen samples with normal counts of spermatozoa (greater than 20 X 10(6)/ml) had higher levels of ATP than samples from patients with oligozoospermia. Spermatozoa from patients whose semen contained less than 0.60 X 10(-2) nmol ATP/1 million spermatozoa showed a rapid drop in motility over a 4-h period compared with semen samples where the motility remained above 10% motile over this period, the latter samples having ATP levels averaging 3.30 X 10(-2) nmol/1 million spermatozoa.

Extraction and estimation of ATP from human spermatozoa.

This study attempts to provide guidelines for the extraction and estimation of ATP from spermatozoa. The conditions of extraction of ATP from spermatozoa using trichloroacetic acid were optimized. The efficiency of this extraction procedure was compared to that using boiling Tris buffer. Three commercially available kits which use the firefly luciferase assay for ATP and two luminometers were evaluated for the measurement of the spermatozoa extracts. Elevated levels of Mg2+ and/or Ca2+ did not interfere with the extraction of ATP by trichloroacetic acid or with the subsequent estimation of the nucleotide.

Treatment of chancroid with erythromycin. A clinical and microbiological appraisal.

One hundred and thirty seven patients presenting with genital ulcerations from which Haemophilus ducreyi was isolated were treated with erythromycin stearate 500 mg every six hours for seven days. Of these, 91 (66%) had associated inguinal lymphadenopathy. Only two of the 100 patients who returned after one week showed no clinical improvement. Despite decrease in size H ducreyi was reisolated from the ulcers of three patients, two of whom had not complied with treatment. The patients were treated for a further week either with erythromycin or with a placebo preparation and on day 14 no discernible difference in clinical response was evident. H ducreyi was not reisolated from any lesion. In contrast, the natural course of development of associated lymphadenopathy was not modified by treatment. H ducreyi was not, however, isolated from any gland after the start of treatment. Side effects attributable to erythromycin were minimal and treatment had to be discontinued in only two patients. This study clearly indicates that treatment with erythromycin for one week results in rapid healing of lesions and the elimination of H ducreyi from both ulcers and associated lymph glands.

Isolation of Haemophilus ducreyi from genital ulcerations in white men in Johannesburg.

An analysis of sexually acquired genital ulcerations in 31 White patients who were examined microbiologically in Johannesburg showed Haemophilus ducreyi to be the causative agent in 23 (74%), whereas syphilis was the confirmed diagnosis in only 6 (19%). All the H. ducreyi isolates produced beta-lactamase. Previously, chancroid was considered to be an infrequent cause of genital ulceration in this population group. Unlike those with syphilitic ulceration, patients with chancroid usually do not respond to penicillin. The improved isolation procedures for H. ducreyi now enable the laboratory to confirm most cases.

Antimicrobial susceptibility of 103 strains of Haemophilus ducreyi isolated in Johannesburg.

Of 103 strains of Haemophilus ducreyi isolated in Johannesburg, 96 produced beta-lactamase and were resistant to penicillin and ampicillin. Most strains showed resistance to tetracycline, sulfisoxazole, and sulfamethoxazole. All isolates were susceptible to rifampin, erythromycin, and cefoxitin, moderately susceptible to trimethoprim-sulfamethoxazole (1:19) and minocycline, and somewhat less susceptible to doxycycline.

Plasmid-coded ampicillin resistance in Haemophilus ducreyi.

Seven of the 96 ampicillin-resistant isolates of Haemophilus ducreyi reported in the preceding article (Bilgeri et al., Antimicrob. Agents Chemother. 22:686-688, 1982) were investigated and found to harbor plasmids of 3.95, 5.2, 5.8, and 6.4 megadaltons. All except the 5.8-megadalton plasmid have been shown to code for beta-lactamase. The 6.4- and 5.2-megadalton plasmids of three isolates were conjugally transferable to a streptomycin-resistant mutant of H. ducreyi at high frequencies, perhaps due to the presence in these strains of a high-molecular-weight plasmid.