- Volume 41, Issue 6, 1994

Two commercially available media recommended for the isolation and rapid identification of Escherichia coli from urinary tract infections were supplemented with L-phenylalanine and L-tryptophan. The non-selective medium proved suitable for the direct detection of lactose fermentation, β-glucuronidase and phenylalanine deaminase activities, indole production and the oxidase test. It was highly efficient in making a presumptive identification at species level of the most common gram-negative urinary pathogens, E. coli, Proteus mirabilis and Pseudomonas aeruginosa, that account for c. 85 % of all urinary isolates. Among the gram-positive isolates, most colonies were non-fluorescent and could be separated into staphylococci and enterococci on the basis of the catalase test. Fluorescent colonies were found to be Staphylococcus haemolyticus isolates, 61% of which were fluorescent. The selective medium proved suitable for the same biochemical tests, with the exception of indole, which was not visible against the red colour of the medium. Therefore, the differentiation of P. mirabilis from other Proteus-Providencia species was impossible on this medium.

In serological typing of Klebsiella pneumoniae strains from human, equine and environmental sources, the capsular identity of many isolates could not be determined because of serological cross-reactivity. A panel of 91 bacteriophages able to lyse each of the 77 capsular serotypes of K. pneumoniae was isolated and tested for the ability to distinguish between strains in a collection of 17 clinical isolates of K. pneumoniae which exhibited crossreactivity with two or more capsular type sera. Most isolates could be assigned a capsular type by performing a simple streak test with bacteriophage, although some required the application of an efficiency of plating analysis to discern capsular type. Bacteriophage typing was found to be an effective, inexpensive and clinically practical adjunct to serotyping in distinguishing serologically cross-reactive K. pneumoniae isolates, irrespective of their origin.

One hundred and sixty-eight isolates of Escherichia coli obtained in Italy from 112 children with diarrhoea and 56 age-matched controls were examined by the HEp-2 cell adhesion assay. Sixteen strains showed localised adherence (LA), 29 showed diffuse adherence (DA) and eight strains showed aggregative adherence (AA). No adhesion pattern was significantly associated with disease. Strains that showed LA or AA were further characterised by serotyping, fluorescent actin staining (FAS) test and hybridisation with the EPEC adherence factor (EAF), E. coli attaching and effacing (eae) and enteroaggregative (EAgg) DNA probes. Strains that showed poor LA were FAS-negative, did not belong to EPEC serotypes and did not hybridise with EPEC probes. Conversely, the two strains that showed a good LA pattern belonged to serotype O128: H2, were FAS positive and hybridised with the eae probe. No isolate hybridised with the EAF probe. Only three of the eight strains with the AA pattern hybridised with the EAgg probe. Probe positivity correlated with the ability to produce clumps at the surface of the liquid culture and to agglutinate rat erythrocytes. In two of these EAgg probe-positive strains, electronmicroscopy revealed the presence of fibrillar bundles which seem to mediate bacterial aggregation.

Forty-seven sera that gave positive results in tests for hepatitis B surface antigen and core antibody were examined for the presence of “e” antigen and “e” antibody by various commercially available assays. Considerable discordance was observed between results of tests performed on the same sample in different assays. Examination of the sera for the presence of hepatitis B DNA failed to resolve the discrepancies. Increasingly, “e” antigen and its antibody are used as measures of infectivity in carriers of hepatitis B. The absence of reliable tests has implications for patients, for infection control within hospitals and for the implementation of Department of Health guidelines on safe working practices for hepatitis B-infected health care workers.

A 66-kDa protein (TB66) was purified from culture filtrate (CF) and cell sonicate (CS) of Mycobacterium tuberculosis H37Rv by immobilised metal affinity chromatography (IMAC) on a Ni-nitrilotriacetic acid (NTA) column. TB66 was found to be a fibronectin-binding protein as determined by ELISA and could be purified by affinity chromatography with fibronectin-Sepharose. A similar 66-kDa protein could be isolated also from M. bovis, M. bovis BCG, M. africanum and M. tuberculosis H37Ra by IMAC, but not from any other mycobacteria. The NH2-terminal amino-acid sequence of TB66 from H37Rv and M. bovis was identical and showed 85% homology with the N-terminal sequence of bovine serum albumin (BSA). A monoclonal antibody (MAb) OD4AG3 recognised a heat-stable and trypsin-sensitive epitope near the C-terminal end of TB66. This MAb also recognised the 66-kDa protein isolated from the other members of the M. tuberculosis complex. In tests of immunogenicity, TB66 elicited a delayed type hypersensitivity reaction in guinea-pigs immunised with either TB66 or with M. tuberculosis H37Rv. TB66 also elicited an antibody response in immunised guinea-pigs and stimulated murine macrophages to produce tumour necrosis factor.

Three hundred isolates of Staphylococcus aureus from wound swabs were examined for the production of toxic shock syndrome toxin 1 (TSST-1). The isolates were collected from community patients, surgical inpatients and from patients in the Regional Burns Unit, Booth Hall Children’s Hospital, Manchester. The overall incidence of toxin production was 17% and there was no significant variation between the sources of the strains. All 55 TSST-1-producing strains were grown in sublethal concentrations of five topical antimicrobial compounds and the level of toxin produced was determined and compared with the amount produced in a control broth after incubation for 24 h. The effects of sublethal concentrations of the compounds on TSST-1 production were strain dependent; some compounds tended to increase production (at least four-fold) and some tended to decrease production (at least fourfold). Some of the strains showed an increase in toxin production in the presence of chlorhexidine gluconate/cetrimide solution and silver sulphadiazine cream whereas 18%, 42% and 47% of the strains showed a decrease in toxin production in the presence of povidone iodine solution, stabilised hydrogen peroxide cream and mupirocin ointment, respectively. Preliminary results suggest that silver sulphadiazine cream induces toxin formation earlier in the growth cycle.