Endotoxin contamination of Foley catheters associated with fevers following transurethral resection of the prostate.

In 1980 an investigation was conducted due to an apparent cluster of fevers following transurethral resections of the prostate ( TURP ), where the presence of prostatitis or urinary tract infections ( UTIs ) could not account for most cases, and the usage of antimicrobials did not prevent them. When unused, prepackaged , sterilized samples from 13 lots of triple lumen catheters were analyzed, four were found to contain high levels of endotoxin (ET), with a range of 49,150-greater than or equal to 6.25 ng/catheter. Additionally, these lots were highly pyrogenic to rabbits. The maximum incidence of febrile patients (42%) correlated with usage of catheters from the lot where ET levels were the highest. The febrile rate for a second urologist, who used single lumen catheters, was less (12/33 v 0/12). Further consideration should be given to sterile operative equipment which may still be pyrogenic.

Antimicrobial susceptibilities of nutritionally variant streptococci.

Seventeen strains of nutritionally variant streptococci were examined for susceptibility to 15 antimicrobial agents. All strains grew in blood culture medium containing blood and blood products or, in the absence of blood or blood products, in broth containing glucose and pyridoxal hydrochloride. Growth was enhanced by incubation in an atmosphere containing 5%-10% CO2 or, in some cases, was CO2-dependent. Rifampin, penicillin, clindamycin, and erythromycin were the most active antibiotics tested with minimal bactericidal concentrations of 2, 1, 2, and 2 microgram/ml, respectively, for 90% of the strains; the corresponding values for vancomycin and streptomycin were 32 and 16 microgram/ml, respectively.

Comparison of the effects of arabinosyladenine, arabinosylhypoxanthine, and arabinosyladenine 5'-monophosphate against herpes simplex virus, varicella-zoster virus, and cytomegalovirus with their effects on cellular deoxyribonucleic acid synthesis.

In a single line of human foreskin fibroblasts, minimum inhibitory concentrations (MICs) and the minimum intracellular virus inactivation concentrations (MIICs) of arabinosyladenine, arabinosylhypoxanthine, and arabinosyladenine 5'-monophosphate were assayed for a number of recent isolates of herpes simplex virus types 1 and 2 (HSV-1, HSV-2), varicella-zoster virus (VZV), and cytomegalovirus (CMV). (The term MIIC is used here to describe the selective qualitative intracellular inhibition of the virus inoculum in the primary tissue cultures. The inoculum is not recoverable in subcultures free of antiviral agent.) MICs and MIICs of each of the antiviral agents were readily obtained for each strain of HSV-1, HSV-2, and VZV tested, but all seven strains of CMV tested were much more resistant. At the endpoint, there was little variation in the MICs or MIICs among strans of the same virus. Final MIC results for HSV-1 and HSV-2 were complete after 3 days of incubation; CMV and VZV results required as long as 6 days. The MIC for each herpesvirus increased with incubation, but at the endpoint the MIC and MIIC were approximately equal. VZV was most susceptible to each drug, followed by HSV-1 and HSV-2. The latter two viruses were quite similar. There was no difference in antiviral susceptibilities among any of the strains of HSV-1, HSV-2, VZV, or CMV tested. The toxicities of arabinosyladenine, arabinosylhypoxanthine, and arabinosyladenine 5'-monophosphate were simultaneously compared by using both microscopic cytotoxicity and inhibition of uptakes of [14C]thymidine into cellular deoxyribonucleic acid and of 14C-labeled amino acids into protein. The selective inhibition of each antiviral agent against viral and cellular deoxyribonucleic acid polymerases was confirmed. Simultaneous assays of antiviral and anticellular activities of antiviral agents may be useful in projecting further in vivo experiments.