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ABSTRACT:We study the effect of a state-level mandate on renewable heating technologies on the housing market. The mandate requires a minimum share of 10% renewable energy sources when changing the heating system in the existing building stock. The mandate could lower the relative price of homes in the existing building stock. We implement a two-stage difference-in-differences nearest neighbor matching approach to identify the effect on prices taking advantage of differences in regulation by location and vintage of the building stock. We find no evidence of a negative effect of the mandate on housing prices.

The manufacturing sector accounts for a substantial share of the German gross domestic product, employment and carbon emissions. Therefore, reducing its energy use and carbon emissions is of crucial importance to Germany’s energy Transition. In this paper, we analyse energy use patterns in German manufacturing between 2003 and 2017, using rich administrative micro-data. We find that although the manufacturing sector has been faced with rising energy costs as a share of total costs, energy use has not declined except briefly during the economic crisis. We also find that energy intensity, and to a larger degree, carbon intensity follow a decreasing trend between 2003 and 2017. The stronger response of the latter variable can be attributed to changes in the fuel mix.

ABSTRACTThe activities of BAL9141 (formerly Ro 63-9141), a novel pyrrolidinone-3-ylidenemethyl cephalosporin, against 244 strains of gram-negative nonfermenters were evaluated. The overall MIC at which 50% of isolates are inhibited (MIC50) and the overall MIC90were 2 and 64 μg/ml, respectively, which are similar to those of imipenem, lower than those of the other cephalosporins tested, amoxicillin, and the ticarcillin-clavulanic acid combination, and much higher than those of ciprofloxacin. BAL9141 shows species-dependent activity in vitro against a variety of gram-negative nonfermentative pathogens.

Four commercial slides were compared with in-house slides for the detection of immunoglobulin G (IgG) againstBartonella henselaein 58 healthy persons from a rural region by an indirect immunofluorescence assay. MRL-BA slides (MRL Diagnostics, USA) and Virion slides (Virion, Switzerland) with agar-derivedBartonella henselaeshowed IgG titers of ≥ 1∶256 in 44.8% and 51.7%, respectively, whereas Bion slides (Bios, Germany), MRL-Vero slides (MRL Diagnostics), and in-house slides with cell-associatedBartonella henselaeshowed such titers in 3.4%, 5.1% and 3.4%, respectively. The MRL-Vero slides (BartonellaIgG substrate slides, MRL Diagnostics) were further evaluated with 26 patients with cat scratch disease, 20 patients with lymphadenopathy not due to cat scratch disease, 100 blood donors from an urban area, and 120 blood donors from a mixed urban/rural area. In our mixed urban/rural population the IgG titer of 1∶256 had a sensitivity of 84.6% and a specificity of 93.4% for the serodiagnosis of cat scratch disease. Seroprevalence was higher in blood donors from the mixed area (50.8%) than from the urban area (37%). MRL-Vero slides were considered useful for the serodiagnosis of cat scratch disease by indirect immunofluorescence and have replaced our in-house system. However, patients with low IgG titers should be retested three to four weeks after initial sampling to demonstrate a possible rise of IgG titers in paired sera.

Summary Thein vitro activity of the free acid of cefetamet pivoxil (Ro 15-8075) was tested against 355 clinical isolates, namely enteropathogenic bacteria, glucose non-fermentative gram-negative rods (excludingPseudomonas aeruginosa) andLegionella pneumophila. Ceftriaxone was included in the study as reference compound. Although the free acid of the orally active cephalosporin was generally weaker than ceftriaxone, it inhibited 88.2% and 94.5% of Enterobacteriaceae and Vibrionaceae at a concentration of 4 mg/l and 8 mg/l or less, respectively.Campylobacter jejuni proved resistant to both compounds. The activity of the new compound against glucose non-fermentative gram-negative rods was generally insufficient to be of promise for broad clinical use. Although the compound was at least twofold more active than ceftriaxone againstPseudomonas acidovorans, Pseudomonas alcaligenes andPseudomonas cepacia, the former was at least two dilution steps less active than the latter against 14 species of the other less common glucose non-fermentative organisms.

Summary The activity of penicillin G, ampicillin, carbenicillin, ticarcillin, azlocillin, mezlocillin and piperacillin against 102 ß-lactamase-producing, methicillin-sensitive strains ofStaphylococcus aureus was determined by agar dilution (method A) and broth microdilution (method B) techniques. By NCCLS breakpoint criteria, 4% of the strains were “sensitive” to penicillin and ampicillin, and almost 100% were “sensitive” to the other drugs when method A was used. Results with method B were only significantly lower as far as the cumulative percentage of strains “sensitive” to azlocillin, mezlocillin and piperacillin was concerned (63–71%). Bactericidal effects at “sensitive” levels were observed in 0–2% (penicillin, ampicillin), 31–35% (carbenicillin, ticarcillin) and 10–14% (azlocillin, mezlocillin, piperacillin). While differences in MIC and MBC levels ranged from 0 to 8 dilution steps, tolerance (a >32-fold difference) was seen in at least 9–22% of all strains (depending on the drug tested); experimental limitations, however, excluded a determination of tolerance in all our strains. In a semi-quantitative nitrocefin assay, “strong” ß-lactamase production was correlated to high MIC and/or MBC levels.

Summary Microbiological monitoring of potential sources of hospital-acquired infections requires a knowledge of the risk of infection connected with each item that may be monitored. While there are large numbers of potential sources for infection present in a hospital, it seems — in the light of past experience — impossible to devise a program that would serve to pinpoint all “dangerous” sources before transmission would occur. It is recommended, however, that small-scale programs be instituted in every hospital so as to mainly ensure the maintenance of aseptic and antiseptic techniques.

Summary The significance of enterococci in the blood cultures of 79 adult patients encountered in a 21-month period was reviewed by means of clinical data. One blood culture consisted of an aerobic and an anaerobic bottle. Patients were divided according to the clinical picture into those with “likely”, “possible”, and “dubious” septicemia. Those with “likely” septicemia showed significantly more positive sets and more often two positive bottles in a single set taken on the same day than patients in the other categories. They also grew cultures with shorter detection times, with 90% of all cultures eventually yielding enterococci within three days after collection. Finally, probability figures relating positivity in one or two bottles to detection time and category of significance are presented. They may be used prospectively to assess the chances of a blood cultures reflecting any of the three above categories.

Summary Forty-eight patients with blood cultures positive for Staphylococcus aureus were classified according to clinical criteria in three groups: “definite”, “possible”, and “doubtful” septicemia. Using traditional blood culture sets with two bottles (thioglycollate and tryptic soy broths), we found that patients with “definite” septicemia always showed more than one positive bottle per day if more than one set was drawn, that the mean detection time was 1.7 days, and that 95% of the first positive bottles and 92% of all positive bottles grew within two days of incubation. Patients with “doubtful” septicemia were more often (88%) positive in one bottle only, the mean detection time for all bottles was 3.7 days, and only 35% of the first positive bottles and 33% of all positive bottles yielded growth within two days. “Possible” cases took a position between these two extremes but tended more towards the “doubtful” cases. The implications of these findings for the interpretation of blood cultures with S. aureus are discussed.

Abstract:  The Swiss External Quality Assessment Scheme in Bacteriology and Mycology was created in 1980 and has been organised since 1983 by the Department of Medical Microbiology in Zurich. The number of Swiss participants has steadily risen from 66 in 1989 to 92 in 1996. Twelve bacterial and fungal strains are sent to the participants in four despatches, each containing three specimens, per year. Scores are allocated per specimen and range between 0 and 1. Participants with mean scores of ≤0.75 are considered poor performers. The mean scores increased from 0.85 in 1992 to 0.91 in 1996. This improvement can be attributed to the educational effect of the external quality control scheme, since all participants receive a detailed discussion for each specimen together with their individual results. On average, both large University and Cantonal (state) laboratories as well as private laboratories show satisfactory performance. In particular, laboratories officially recognised by the Swiss Federal Office of Public Health (SFOPH) rate better than non-recognised participants. Many small regional hospital laboratories, most of them not SFOPH-recognised, are often among the poor performers. They are often managed by technical staff and lack a trained microbiologist. The recently introduced legislation in Switzerland renders participation in external quality assessment schemes compulsory, and all clinical microbiology laboratories are required to employ qualified microbiologists. This will certainly help to improve the quality standards of all laboratories performing microbiological tests.

Abstract: Several species of Enterobacteriaceae were checked for acid formation from some carbohydrates or alcohols in OF medium [OF Basal Medium, Baltimore Biological Laboratories] and in a traditional ldquofermentation brothrdquo. After selection of those species that formed acid only oxidatively or fermentatively in OF, it was found that acid formation in the fermentation broth could reflect fermentation or oxidation, but that it was not necessarily related to either. In oxidative species, it occurred less frequently than oxidation in OF and was usually delayed. Fermentative species (in OF) either yielded acid in fermentation broth or did not, depending on the species. Thus, OF media cannot be substituted for traditional broths, although they may be of value in differentiating certain species.

The API 20 NE (Rapid NFT) system for identification of non-enteric aerobic gram-negative rods was evaluated using 431 strains of species covered by the analytical profile index and previously identified by conventional methods. In an analysis of several parameters, 343 (80 %) of the strains were identified correctly with good to excellent probabilities of positive reactions (80.0–99.9%), 190(55%) of these within 24 h; 74(17%) yielded primary identifications with lower probabilities. Only 3 % of the strains could not be correctly identified. The system is very satisfactory for routine use, but could be improved by modified pre-testing of the strains and by including more species in the profile index.

Coryneform bacteria are aerobically growing, asporogenous, non-partially-acid-fast, gram-positive rods of irregular morphology. Within the last few years, there has been a massive increase in the number of publications related to all aspects of their clinical microbiology. Clinical microbiologists are often confronted with making identifications within this heterogeneous group as well as with considerations of the clinical significance of such isolates. This review provides comprehensive information on the identification of coryneform bacteria and outlines recent changes in taxonomy. The following genera are covered: Corynebacterium, Turicella, Arthrobacter, Brevibacterium, Dermabacter. Propionibacterium, Rothia, Exiguobacterium, Oerskovia, Cellulomonas, Sanguibacter, Microbacterium, Aureobacterium, "Corynebacterium aquaticum," Arcanobacterium, and Actinomyces. Case reports claiming disease associations of coryneform bacteria are critically reviewed. Minimal microbiological requirements for publications on disease associations of coryneform bacteria are proposed.

A total of 105 patients (mean age 57, range 15 to 90) with serious infections were treated with intravenous ceftazidime, usually 2 g 8-hourly. Most patients had complicating factors such as major surgery, cancer, chronic obstructive lung disease, catheters or anatomical abnormalities. Eighty-seven infectious episodes in 77 patients could be assessed for efficacy. Bacteraemia was diagnosed in 26% of these episodes. Seventy-five per cent of infections were due to Gram-negative bacteria, Pseudomonas aeruginosa being the most frequent. The major sites of infections were the lower respiratory tract (30), the urinary tract (28), the soft tissues (9), the biliary tract (4), bones (4) and the ears (4). Overall, 67% of the patients were cured, 20% improved, 7% relapsed and 6% failed to respond. Among the 27 infections due to Ps aeruginosa, only two failures (in the same patient) and four relapses were recorded. However, in the two failures and in three other cases with persistent Ps. aeruginosa colonisation, the organism had become resistant to ceftazidime. Three failures were recorded in the seven Staphylococcus aureus infections included in this study. Superinfection occurred in four patients. Adverse events included rash (6), Clostridium difficile toxin-induced diarrhoea (3), transaminase elevation (3), weakly positive Coombs test (10). Ceftazidime appears to be safe and effective for the treatment of severe Gram-negative infections, including those caused by Ps. aeruginosa.

Decarboxylase/dihydrolase activities inAeromonas spp. are important as diagnostic tools and indicators of enterotoxin production. We have analyzed the following media at 25°C, 29°C, and 37°C, respectively, for their ability to detect such activities: Møller's, Falkow's, and Fay and Barry's (F&B) containing ornithine, lysine, and arginine, respectively, as well as motility-indole-ornithine (MIO) medium and lysine decarboxylase broth with 0.1% agar (LDC). In order to retain ornithine negativity, but to get as much positivity as possible for arginine, optimal incubation conditions were 29°C for 96 h (Møller), 48 h (Falkow, MIO, and LDC), and 24 h (F&B). The F&B medium proved to be the most sensitive for the detection of lysine decarboxylase, a positive test being highly correlated with the two speciesA. hydrophila andA. sobria, and we suggest its use for routine detection of decarboxylase/dihydrolase activities.

Abstract: The finding ofErwinia herbicola (Enterobacter agglomerans) in blood cultures of 15 inpatients, during a 53/4-year period in a nonepidemic context, was analyzed for clinical significance. Mixed cultures were seen in 5 patients; multiple sets were taken in 10 patients. In only 6 patients couldErwinia be significantly correlated with clinical septicemia; in 9, it was of doubtful significance, more likely reflecting transient bacteremia than skin contamination or laboratory handling. These findings contrast to previous reports that stress a preponderance of clinically significant strains ofEnterobacter species andErwinia from blood cultures. The only bacteriological differences between the “significant” and “doubtful” groups involved the time required to detectErwinia.

We studied nine solid and two liquid media for their suitability to select Aeromonas and Plesiomonas spp. from human stools, using artificially contaminated samples as well as 254 samples from outpatients with and without diarrhea. Media with optimal sensitivity and specificity for Aeromonas spp. were alkaline peptone-water, Trypticase soy broth with ampicillin, inositol-brilliant green-bile salts agar, dextrin-fuchsin-sulfite agar, xylose-sodium desoxycholate-citrate agar, and Pril-xylose-ampicillin agar. For Plesiomonas sp., alkaline peptone-water and inositol-brilliant green-bile salts agar were optimal. Four strains of Aeromonas spp. were detected in patient samples with these media.

The process of continuous ambulatory peritoneal dialysis has provided a useful, relatively inexpensive, and safe alternative for patients with end-stage renal disease. Infectious peritonitis, however, has limited a more widespread acceptance of this technique. The definition of peritonitis in this patient population is not universally accepted and does not always include the laboratory support of a positive culture (or Gram stain). In part, the omission of clinical microbiological findings stems from the lack of sensitivity of earlier microbiological efforts. Peritonitis results from decreased host phagocytic efficiency with depressed phagocytosis and bactericidal capacity of peritoneal macrophages. During episodes of peritonitis, fluid movement is reversed, away from the lymphatics and peritoneal membrane and toward the cavity. As a result, bloodstream infections are rare. Most peritonitis episodes are caused by bacteria. Coagulase-negative staphylococci are the most frequently isolated organisms, usually originating from the skin flora, but a wide array of microbial species have been documented as agents of peritonitis. Clinical microbiology laboratories need to be cognizant of the diverse agents so that appropriate primary media can be used. The quantity of dialysate fluid that is prepared for culture is critical and should constitute at least 10 ml. The sensitivity of the cultural approach depends on the volume of dialysate, its pretreatment (lysis or centrifugation), the media used, and the mode of incubation. The low concentration of microorganisms in dialysate fluids accounts for negative Gram stain results. Prevention of infection in continuous ambulatory peritoneal dialysis patients is associated with the socioeconomic status of the patient, advances in equipment (catheter) technology, and, probably least important, the application of prophylactic antimicrobial agents.

Over a 6-year period 11 yellow-pigmented gram-positive rods (GPRs) with an oxidative carbohydrate metabolism were isolated from clinical specimens or were received as reference cultures and tentatively identified as "Corynebacterium aquaticum" according to the guide of Hollis and Weaver for the differentiation of GPRs (D. G. Hollis and R. E. Weaver, Gram-Positive Organisms: a Guide to Identification, 1981). Because these isolates seemed to be rather heterogeneous, comparative analyses with the type strain of "C. aquaticum" as well as six type strains of species belonging to the genus Aureobacterium were performed by biochemical and chemotaxonomic methods. Only four clinical strains were found to be "C. aquaticum," whereas seven strains were found to belong to the genus Aureobacterium. Discriminative phenotypic reactions between "C. aquaticum" and Aureobacterium spp. included hydrolysis of gelatin and casein (both reactions negative for "C. aquaticum" strains but positive for most Aureobacterium strains). Moreover, peptidoglycan analysis provided a reliable means of differentiating yellow-pigmented GPRs at the genus level (diaminobutyric acid as the interpeptide bridge in "C. aquaticum" and glycine-ornithine as the interpeptide bridge in Aureobacterium spp.). Antimicrobial susceptibility testing revealed that vancomycin showed an intermediate MIC for three of the four clinical "C. aquaticum" isolates, whereas all Aureobacterium strains were susceptible to vancomycin. To our knowledge, this is the first report outlining the isolation of Aureobacterium spp. from clinical specimens. However, Aureobacterium isolates could not be identified to the species level by the tests used in the study.

Nonfermenting coryneform bacteria identified as Brevibacterium spp. were isolated from routine clinical specimens. Four strains were derived from peritoneal fluid and has presumably been involved in the pathogenesis of continuous ambulatory peritoneal dialysis peritonitis. Another five isolates most probably represented skin contaminants. Cell wall and lipid analyses confirmed the genus identification. Strains in this taxon are difficult to distinguish from other biochemically inactive and nonmotile coryneform species but show characteristics cellular fatty acid profiles. In vitro susceptibilities to commonly used antibiotics were determined.

Over a 3-year period, an adult cystic fibrosis patient underwent eight episodes of pulmonary exacerbation of his disease. At least one of two different strains of Bordetella hinzii could be isolated from sputum samples in every instance. The differentiation of B. hinzii from related taxa and its role as an etiologic agent of infections are discussed. The two isolates of B. hinzii reported are the third and fourth human-derived strains described in the literature.

Fifteen strains of CDC group 1 coryneform and biochemically similar bacteria were isolated from clinical specimens. Of the 15 strains isolated, 11 were derived from abscesses and purulent lesions, mostly from the upper part of the body, and 3 were grown from blood cultures. Nine strains were associated with mixed anaerobic but no other aerobic flora. Seven strains exhibited the classical biochemical profile of CDC coryneform group 1; however, eight strains were unable to reduce nitrate and were called "group 1-like." Other reactions to differentiate CDC group 1 and group 1-like coryneform rods include alpha-hemolysis on human blood agar, fermentation of adonitol, and the presence of alkaline phosphatase. Fifteen strains showed marked CAMP reactions on different erythrocyte agars. Gas-liquid chromatography of volatile and nonvolatile fatty acids as well as cellular fatty acid patterns and the composition of cell wall components suggest that CDC group 1 and group 1-like coryneform bacteria do not belong to the genus Corynebacterium but possibly to the genus Actinomyces or Arcanobacterium. DNA-DNA hybridization studies revealed that group 1 and group 1-like strains represent different species.

A miniaturized 2-h system for detection of lactosenegative potentially enteropathogenic bacteria on the basis of nine enzymatic tests was evaluated. The system was challenged with 210 strains of lactose-negative and lactose-positive species grown on MacConkey agar. Specific and constant patterns were found forSalmonella, ShigellaA-C,Yersinia enterocolitica, Aeromonasspp. andVibrio cholerae. Shigella sonneiandHafnia alveihad an identical pattern, likewisePlesiomonas shigelloides,halophilic vibrios andPseudomonas aeruginosa.

ABSTRACTThe new VITEK 2 system (bioMe´rieux) was evaluated at two independent sites with the identification card for gram-negative bacilli (ID-GNB card). Of the 845 strains tested, which represented 70 different taxa belonging to either the familyEnterobacteriaceaeor the nonenteric bacilli, 716 (84.7%) were correctly identified at the species level. Thirty-two (3.8%) additional strains were identified to the species level after the performance of simple, rapid manual tests (oxidase, hemolysis, indole reaction, motility, and pigmentation). For 80 (9.5%) strains, these additional tests did not lead to an identification at the species level but the correct species identification was given among the organisms listed. Only 7 (0.8%) strains were misidentified, and 10 (1.2%) were not identified. Mistakes were randomly distributed over different taxa. Due to the new, more sensitive fluorescence-based technology of the VITEK 2 system, final results were available after 3 h. Since our evaluation was mainly a stress test, it is predicted that the VITEK 2 system in conjunction with the ID-GNB card would perform well under conditions of a routine clinical laboratory in identifying members of the family Enterobacteriaceaeand selected species of nonenteric bacteria. This system is a promising, highly automated new tool for the rapid identification of gram-negative bacilli from human clinical specimens.

The susceptibility patterns of 480 isolates representing six recently defined species of coryneform bacteria (Corynebacterium amycolatum [n = 101], Corynebacterium auris [n = 48], Corynebacterium glucuronolyticum [n = 86], Brevibacterium casei [n = 50], Dermabacter hominis [n = 49], and Turicella otitidis [n = 146]) to 17 antimicrobial agents were determined by an agar dilution method. Most significantly, for C. amycolatum strains the MICs at which 90% of isolates are inhibited were > or = 32 micrograms/ml for nearly all agents. However, all 480 strains examined were susceptible to glycopeptide antibiotics.

The in vitro activities of Ro 40-6890, the active metabolite of a novel orally absorbable cephalosporin ester, Ro 41-3399, against 164 nonfastidious aerobic gram-negative rods of predominantly intestinal origin from patients with diarrhea were evaluated by the agar dilution method recommended by the National Committee for Clinical Laboratory Standards. Ro 40-6890 was inhibitory (MIC for 90% of isolates [MIC90], 0.12 micrograms/ml) against the majority of intestinal members of the families Enterobacteriaceae and Vibrionaceae (Vibrio spp., Aeromonas spp., and Plesiomonas shigelloides). The potency of Ro 40-6890 was very similar to that of cefotaxime (MIC90, 0.12 micrograms/ml) and distinctly higher than those of cefadroxil (MIC90, > or = 128 micrograms/ml) and amoxicillin-clavulanic acid (MIC90, 32 micrograms/ml-2 micrograms/ml).

Zusammenfassung Von drei Patienten mit extraintestinalen Infektionen konnten halophile Vibrionen gezüchtet werden. Im ersten Fall wurde V. alginolyticus von einer Mittelohrinfektion isoliert, im zweiten ein ornithin-negativer Vibrio von einer Gallenblasengangraen. Beim dritten Patienten lag eine mit V. parahaemolyticus mischinfizierte Beinverletzung (nach Flugzeugabsturz) vor. Die Charakteristika der Stämme und ihre Differential-diagnose werden beschrieben. Die Resultate der Sensibilitätsteste waren teilweise von der Salzkonzentration im Medium abhängig. Während die Stämme von V. alginolyticus und V. parahaemolyticus aus dem Meerwasser stammen dürften, ist die Herkunft des Vibriosp.-Stammes unklar. Die Pathogenität des V. parahaemolyticus erscheint in unserem Falle zweifelhaft.

Ohne Zusammenfassung:

von Graevenitz, Alexander(Yale University, New Haven, Conn.). Genetic transfer of streptomycin and aminopropanolstreptomycin resistance. J. Bacteriol. 88:960–964. 1964.—Transduction and conjugation experiments with Staphylococcus aureusand Escherichia colisuggest that resistance to streptomycin (S) and aminopropanolstreptomycin (A) is due to the same mutation arising in a single step at the locus str. The high occurrence of SrAscells (1 to 3%) in an SrArpopulation was noted. From genetic crosses of SrAswith SsAscells, it can be concluded that there is a suppressor locus su-Aadjacent to, but separable by recombination from, the strlocus. It modifies the genotype SrArto the phenotype SrAs.

ABSTRACTIdentification of coryneform bacteria to the species level is important in certain circumstances for differentiating contamination and/or colonization from infection, which influences decisions regarding clinical intervention. However, methods currently used in clinical microbiology laboratories for the species identification of coryneform bacteria are often inadequate. We evaluated the MicroSeq 500 16S bacterial sequencing kit (Perkin-Elmer Biosystems, Foster City, Calif.), which is designed to sequence the first 527 bp of the 16S rRNA gene for bacterial identification, by using 52 coryneform gram-positive bacilli from clinical specimens isolated from January through June 1993 at the Mayo Clinic. Compared to conventional and supplemented phenotypic methods, MicroSeq provided concordant results for identification to the genus level for all isolates. At the species level, MicroSeq provided concordant results for 27 of 42 (64.3%)Corynebacteriumisolates and 5 of 6 (83.3%)Corynebacterium-related isolates, respectively. Within theCorynebacteriumgenus, MicroSeq gave identical species-level identifications for the clinically significantCorynebacterium diphtheriae(4 of 4) andCorynebacterium jeikeium(8 of 8), but it identified only 50.0% (15 of 30) of other species (P< 0.01). Four isolates from the genera Arthrobacter,Brevibacterium, and Microbacterium, which could not be identified to the species level by conventional methods, were assigned a species-level identification by MicroSeq. The total elapsed time for running a MicroSeq identification was 15.5 to 18.5 h. These data demonstrate that the MicroSeq 500 16S bacterial sequencing kit provides a potentially powerful method for the definitive identification of clinical coryneform bacterium isolates.

Summary: Two cases ofAerococcus urinae endocarditis are reported. The organism is not included in any database of commercial identification systems at this time. Formation of tetrades and positive reactions for leucine arylamidase and beta-glucuronidase pointed strongly toA. urinae. The cellular fatty acid pattern was similar to that ofAerococcus viridans, with predominantly C16∶0, C18∶1ω9c and C18∶0; the presence of C18∶1ω7t differentiated our isolates fromA. viridans and can support the diagnosis ofA. urinae. Furthermore, susceptibility to penicillin but resistance to cotrimoxazole represents a pattern opposite to that ofA. viridans. Minimal inhibition concentrations of gentamicin and netilmicin were≤64 mg/l but those of tobramycin were≥256 mg/l. Penicillin combined with either gentamicin or netilmicin showed distinct synergy in killing kinetics. These combinations seem to be the appropriate regimen to treatA. urinae endocarditis.

Summary It is evident at this time that enterococci by themselves are able to cause infections outside the bloodstream and the urinary tract only rarely and under very special circumstances in which local defense mechanisms are severely compromised (e.g., by plastic devices). In most instances, they have been found in mixed culture and probably act synergistically with other bacteria to cause damage to the host. They could, however, be carried from their habitat into the bloodstream and eventually cause septicemia. Such a danger is probably heightened if super-colonization is fostered through antibiotics that are ineffective against them, e.g., cephalosporins.

A case of superficial wound infection in a noncompromised host due to a Rhodococcus equi-like organism, acquired from soil, is described. The strain grew poorly at 37 degrees C and showed several differences from wild-type R. equi in biochemical tests and in its fatty acid and mycolic acid compositions.

Summary This is a report on a boy with megacalycosis in whom infectious urolithiasis after eradication ofProteus mirabilis was maintained byCorynebacterium group D2.

AbstractAn otherwise healthy 53-year-old woman underwent intracranial surgery for trigeminal neuralgia. One week later she developed meningitis and bacteremia caused by Pasteurella ureae and was treated successfully with antimicrobials. This organism is known to colonize the respiratory tract in certain individuals and is an extremely rare cause of meningitis or bacteremia. This is the first reported case of bacteremia in an adult.