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Biomedical subjects

B J Mansheim

Publications and source records attributed to B J Mansheim.

15 recordsLinked to original sources

Strongyloides infection and meningitis in an immunocompromised host.

Strongyloidiasis and aseptic meningitis occurred in a renal transplant recipient who was receiving immunosuppressive drugs. Cure followed therapy with antibiotic administration for 3 days combined with oral thiabendazole, suggesting parasitic infection as the most likely cause of meningitis. Awareness of this disease and need for prompt institution of therapy is stressed. Prophylactic administration of thiabendazole is probably preventive.

Adult

Comparative efficacy of piperacillin and penicillin G in treatment of gonococcal urethritis.

The comparative efficacy of 2 g of piperacillin and 4.8 X 10(6) U of penicillin G in the treatment of uncomplicated gonococcal urethritis was assessed in a randomized prospective study. Sixty-five evaluable patients received piperacillin, and 55 received penicillin G. All patients received either therapy were cured of gonorrhea. We conclude that piperacillin is as efficacious as aqueous procaine penicillin G in the therapy of uncomplicated gonococcal urethritis.

Gonorrhea

Role of surface fimbriae (fibrils) in the adsorption of Actinomyces species to saliva-treated hydroxyapatite surfaces.

We studied the adsorption, morphological, and serological characteristics of selected Actinomyces and related species. Evaluation of uranyl acetate-stained cells by electron microscopy revealed wide variations among strains in the frequency of surface fimbriae. These variations did not always correlate with the percent adsorption to saliva-treated hydroxyapatite of the various Actinomyces strains. However, two strains of Rothia dentocariosa possessing no surface fimbriae and five strains of A. israelii possessing very few surface fimbriae exhibited feeble adsorption to saliva-treated hydroxyapatite. Although the calculated number of adsorption sites on saliva-treated hydroxypatite did not vary widely among the strains tested, significant differences were observed in the affinities calculated for some species or serotypes. The mean affinities for strains of A. viscosus serotype 2 and A. naeslundii serotype 3 were similar, and these strains adsorbed well to saliva-treated hydroxyapatite. The mean adsorption and affinity for the A. naeslundii strain serotype 1 and all strains of A. israelii tested were significantly less than those determined for the A. viscosus serotype 2 or A. naeslundii serotype 3 strains. Adsorption inhibition activity of antiserum to strain T14V, previously shown to be solely related to antibodies in immune serum directed against the VA1 fimbria (fibril) antigen, was removed by preadsorption of the antiserum with most A. viscosus and A. naelundii strains, but not with A. israelii strains. This suggests some cross-reactivity among strains of A. viscosus and A. naeslundii but not A. israelii. Adsorption to saliva-treated hydroxyapatite of all A. viscosus and A. naeslundii strains tested was strongly inhibited by fimbriae isolated from A. viscosus strain T14V. Collectively, these data suggest that the adsorption of certain A. viscosus and A. naeslundii strains is mediated by surface fimbriae, many of which appear serologically cross-reactive with strain T14V fimbriae.

Actinomyces

Gonococcal endocarditis.

Two cases of gonococcal endocarditis and their clinical features have been described. This uncommon disease typically presents in a subacute fashion but may progress to a rapidly destructive, lethal process within days. We therefore recommend a conservative approach to therapy for disseminated gonococcal infection.

Adolescent

Immunochemical differences between oral and nonoral strains of Bacteroides asaccharolyticus.

We undertook a morphological and immunochemical comparison of purified outer membrane antigens from oral and nonoral isolates of Bacteroides asaccharolyticus. Electron micrographs of thin sections of whole bacteria revealed a compact, electron-dense capsule external to the outer membrane of oral strains. A loose, web-like material was noted on the surface of several nonoral strains that was distinct from the dense capsule seen on oral strains. Polyacrylamide gel electrophoresis showed distinct differences in the protein band pattern between oral and nonoral isolates; sugar composition was similar with a few exceptions. An indirect fluorescent-antibody test utilizing antiserum to a purified capsular antigen from a single oral strain cross-reacted with all of numerous oral and nonoral strains of B. asaccharolyticus, thereby demonstrating a shared antigen that is species specific for B. asaccharolyticus. However, antibodies to an oral strain-derived capsular antigen were detectable by enzyme immunoassay only in serum from rabbits immunized with oral strains. Thus, definite morphological and immunochemical differences were found between oral and nonoral isolates of B.asaccharolyticus.

Antigens, Bacterial

Detection of anticapsular antibodies to Bacteroides asaccharolyticus in serum from rabbits and humans by use of an enzyme-linked immunosorbent assay.

A sensitive serologic test, the enzyme-linked immunosorbent assay (ELISA), was used to detect serum IgG antibodies directed specifically to a capsular antigen of Bacteroides asaccharolyticus (previously known as Bacteroides melaninogenicus subspecies asaccharolyticus). Anticapsular IgG was measured in 30 specimens of rabbit serum after the animals were immunized with whole B. asaccharolyticus, the two subspecies of B. melaninogenicus, and several other bacterial species. Species-specific anticapsular IgG was demonstrated (P less than 0.001). Levels of anticapsular IgG greater than control levels were likewise detected in serum from two humans, including one patient who had periodontitis and from whom B. asaccharolyticus was isolated, and a laboratory worker who had extensive exposure over a two-year period to B. asaccharolyticus. The ELISA was found to be a relatively simple, sensitive tool for measurement of serum IgG. Its application to detection of immunoglobulins of other classes, including secretory IgA, is anticipated, provided adequate standardization methods are used.

Animals

The cell envelope of the Legionnaires' disease bacterium. Morphologic and biochemical characteristics.

We studied the cell-envelope structure of the Legionnaires' disease (LD) bacterium by electron microscopy and biochemical assays. There were apparent differences in cell structure by electron microscopy using two different prefixation methods. Organisms prefixed with gluteraldehyde had a single surrounding membrane. The typical two-membrane structure of gram-negative bacteria, however, was observed after prefixation with a combination of gluteraldehyde, formalin, and creosol. The cell wall (peptidoglycan) was seen in electron micrographs of plasmolyzed bacteria and in papain-digested cells. Both cytoplasmic and outer membranes were separated by differential centrifugation of spheroplast sonicates followed by sucrose density gradient ultracentrifugation. We identified each membrane by characteristic enzyme activity (cytoplasmic membrane) and 2-keto-3-deoxyoctonate content (outer membrane).

Bacteria

Identification of a subspecies-specific capsular antigen from Bacteroides melaninogenicus subspecies asaccharolyticus by immunofluorescence and electron microscopy.

An indirect fluorescent antibody test was developed with the use of hyperimmune rabbit antiserum to a purified capsular polysaccharide of Bacteroides melaninogenicus subspecies asaccharolyticus. All of 23 strains of B. melaninogenicus subspecies asaccharolyticus were fluorescence-positive in this test. All 11 strains of Bacteroides melaninogenicus subspecies intermedius tested and three strains of Bacteroides melaninogenicus subspecies melaninogenicus were fluorescence-negative. Thirty-one strains of other bacterial species were also fluorescence-negative. The indirect fluorescent antibody test demonstrated the presence of a subspecies-specific capsular antigen from B. melaninogenicus subspecies asaccharolyticus. The capsular antigen was further demonstrated by electron microscopy with ruthenium red, a polysaccharide-staining material.

Animals

Purification and immunochemical characterization of the outer membrane complex of Bacteroides melaninogenicus subspecies asaccharolyticus.

Morphologic study of Bacteroides melaninogenicus subspecies asaccharolyticus by electron microscopy disclosed the presence of a capsule and a cell wall structure otherwise typical of a gram-negative organism. An outer membrane complex was isolated with use of gentle methods. Relative purity of the preparation was confirmed by electron microscopy and by the formation of a single band in a sucrose density gradient. Gel chromatography was used for separation of the major components of the membrane. Antigenicity of the first component, a protein-polysaccharide complex, which cross-reacted with antiserum to another strain of the same subspecies. This component probably represents the capsular antigen and may prove to be the basis for serogrouping. The second membrane fraction differed chemically from the first fraction and represents the lipopolysaccharide component of the outer membrane. Notably, this component lacks 2-keto-3-deoxyoctonate, one of the backbone sugars of aerobic, gram-negative lipopolysaccharides.

Antigens, Bacterial

Immunochemical characterization of surface antigens of Bacteroides melaninogenicus.

Major surface antigens of Bactmbrane complex by gentle methods, purified, and characterized immunochemically. A lipopolysaccharide (LPS) was found to be chemically distinct from the LPS of facultative gram-negative bacteria in that it lacked two core sugars, 2-keto-3-deoxyoctonate and heptose, as well as beta-hydroxymyristic acid, the predominant fatty acid in the lipid A moiety. The LPS was further atypical in that it had a very low level of biologic activity. A capsular polysaccharide was demonstrated morphologically by electron microscopy with ruthenium red staining and a ferritin-labeled antibody technique. This antigen was shown to be subspecies-specific by indirect immunofluorescence. Antibody to the capsular polysaccharide was measured by an enzyme-linked immunospecific assay. The presence of a relatively impotent LPS and a surface capsular antigen may partly explain the rarity of bacteremia and septic shock due to B. melaninogenicus subspecies asaccharolyticus and the common association of this organism with abscess formation.

Animals

Experimental animal models for anaerobic infections.

An experimental animal model that stimulates the mixed aerobic-anaerobic microflora of intraabdominal sepsis was used to study antimicrobial efficacy in vivo. Treatment of infected rats with chloramphenicol resulted in only a modest reduction in the percentage of animals surviving infection with abscesses at necropsy. This unanticipated observation led to further exploration of the predominant anaerobes associated with the experimental infection. In vitro cultures of Bacteroides fragilis, susceptible to chloramphenicol in traditional tests, were capable of reducing chloramphenicol to its aryl amine derivative, which is biologically inactive. In contrast, metronidazole, an antimicrobial agent active against anaerobes, reduced the coli-metronidazole, an antimicrobial agent active against anaerobes, reduced the coli-form-associated mortality in this animal model. Subsequent studies showed that this reduction in mortality is dependent on the presence of an anaerobe and that the levels of Escherichia coli in mixed continuous culture with B. fragilis are reduced by addition of metronidazole. This reduction following addition of metronidazole was not observed either in a pure culture of E. coli or when clindamycin was added to a mixed culture. In a modification of the previously described model, infective material was placed subcutaneously into Wistar rats. Studies with this model suggested that the host's response to bacterial challenge is dependent on the site of infection and that organotropism of the implanted bacterial species is an important determinant of infection.

Abscess