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Professor Hans Gerd Schiefer, known to many of us as a medical microbiologist with a strong interest in infectious diseases, died on October 11, 2014 from complications of a malignant tumor. Born on December 17, 1935 in Wuppertal–Elberfeld, he studied medicine at the universities of Marburg, Munich, and Dusseldorf and interrupted his studies for a 2-year period of work in the biochemistry laboratory of the Federal Institute of Technology in Zurich under the direction of Carl Martius. After receiving his M.D. degree in 1962, he interned in medicine in Duisburg, Essen, and Cologne and again in biochemistry at the University of Cologne and at the Max Planck Institute for Experimental medicine in Gottingen. In 1971, he became a fellow at the Institute of Medical Microbiology of the University of Giessen, qualified in 1972 as a specialist in Laboratory Medicine, and became Assistant Professor for Medical Microbiology and Urogenital and Sexually Transmitted Diseases in 1974. In 1975, he was named Professor at that institution.

1. Alcaide ML, Bisno AL. Pharyngitis and epiglottitis. Infect Dis Clin North Am. 2007;21:449–69. 2. Kaplan EL, Top FH, Dudding BA, Wannamaker LW. Diagnosis of streptococcal pharyngitis: differentiation of active infection from the carrier state in the symptomatic child. J Infect Dis. 1971;123:490–501. 3. Yeh C-F, Li W-Y, Hsu Y-B. Klebsiella pneumoniae pharyngitis mimicking malignancy: a diagnostic dilemma. Infection. 2014;42:1047–50. The case described by Yeh et al. in this journal is certainly unusual but the term “pharyngitis” should not have been used. Pharyngitis has been defined as sore throat, fever, and pharyngeal inflammation characterized by erythema and edema; exudates, vesicles and ulcerations may also be present [1]. Many authors have also counted enlarged or tender lymph nodes among the symptoms [2]. The patient in question, however, did not show any of them, but rather hoarseness and dysphagia, all of which pointed to a spaceoccupying lesion in the hypopharyngeal area. There was no mention of a throat culture, the usual means of a bacteriological diagnosis of pharyngitis [3]. This is more than a semantic issue because Klebsiella pneumoniae has so far not been reported as an agent of uncomplicated pharyngitis [1] and should not be looked for in routine throat cultures. The case report presented ought

Summary: In a 5-year period, 73 coryneform isolates from prosthetic joint and open fracture infections in 60 patients treated in a hospital specialized in orthopedic surgery were speciated. The most frequent species wereCorynebacterium amycolatum, Corynebacterium striatum, Corynebacterium diphtheriae biotypemitis, andCorynebacterium jeikeium. At least 14 isolates were deemed clinically significant as sole agents of infection

Turicella otitidis and Corynebacterium auris, described as new species 20 years ago, have been isolated mainly from the external ear canal and middle ear fluid. While their taxonomic position has been clearly established, their diagnosis in the routine laboratory is difficult. The question of their pathogenic potential in otitis is still open but might be elucidated better if corynebacteria are speciated more often.

Serious infections caused by Rhodotorula spp. are rare and usually occur in immunocompromised people, especially in patients with tumors and long-time use of indwelling central venous catheters. We report a case of Rhodotorula mucilaginosa homograft endocarditis in an otherwise healthy man, which was successfully treated by surgery in combination with amphotericin B and subsequently intraconazole.

Sixty-seven patients with infections in which the recently proposed species Actinomyces neuii was involved were observed during a 4 1/2-year period. Microbiological as well as clinical features of the patients are presented. A. neuii does not cause typical actinomycosis and is detected most often in material from abscesses or infected atheromas. One case of a fatal septicemia caused by A. neuii in a non-immunocompromised host was seen. Antimicrobial susceptibility patterns of A. neuii isolates and results of various treatment regimens are discussed.

Shigella bacteremia in adult patients is rare and is usually associated with immunosuppressive diseases. To date, 12 HIV-positive patients with Shigella bacteremia have been reported in the medical literature. We report a case of Shigella dysenteriae bacteremia in a 39-year-old HIV-positive patient. Although the patient presented with bloody and watery diarrhea, stool cultures failed to grow enteric pathogens. The patient responded well to appropriate antibiotic therapy.

Streptobacillus moniliformis is the causative agent of rat bite fever, with endocarditis being a rare but well-documented complication. We report the case of an HIV-positive man who acquired S. moniliformis endocarditis through a rat bite. No predisposing cardiac lesion was known. He was treated with ceftriaxone 2 g/day i.v. for 3 weeks, gentamicin 120 mg/day i.v. for 2 weeks and penicillin 24x10(6) units/day for 1 week. At the end of the antibiotic therapy he suffered a generalized Candida albicans infection, which was treated with fluconazole for 1 week. He was subsequently discharged in a satisfactory condition.

Two cases of thyroiditis due to Brucella melitensis are reported. Both occurred in foreigners working in Switzerland and presented with characteristic symptoms of thyroiditis which masked those of brucellosis. Cultures were diagnostic. One patient had concomitant thyroid malignancy. Both showed normal thyroid function and were cured following antibiotic treatment.

The activity of penicillin G, ampicillin, carbenicillin, ticarcillin, azlocillin, mezlocillin and piperacillin against 102 beta-lactamase-producing, methicillin-sensitive strains of Staphylococcus 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 greater than 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" beta-lactamase production was correlated to high MIC and/or MBC levels.

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.

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.

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.

The in 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 (excluding Pseudomonas aeruginosa) and Legionella 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 against Pseudomonas acidovorans, Pseudomonas alcaligenes and Pseudomonas 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.

Concentration of peritoneal fluid of continuous ambulatory peritoneal dialysis (CAPD) patients has often been recommended for microbiological examination. This study presents data about the yield of microorganisms of different volumes through centrifugation. Twenty-eight samples of 50 ml and 1000 ml of the same dialysate bags were centrifuged, and assays were made for aerobic and anaerobic organisms on solid media and in enrichment broth. All pairs of 50 ml and 1000 ml samples except one (96%) showed identical results, suggesting that it is unnecessary to centrifuge more than 50 ml of fluid. Furthermore, it seems better to examine two or more consecutive bags per peritonitis episode, since microorganisms were found in seven of nine (77%) such episodes, compared to only five of eight (62%) episodes with only one bag. In addition, significantly more positive cultures were recorded (14 of 17 vs. 5 of 11; p less than 0.05) if samples were taken before administration of antibiotics. One patient's catheter was colonized with bacteria probably arranged in a biofilm. This fact seems to be of particular importance for CAPD patients and should be studied further.

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

Thirty-one species (185 strains) of non-fermentative gram-negative rods (excluding Pseudomonas aeruginosa) as well as 45 strains of Aeromonas spp., 15 strains of Plesiomonas shigelloides and 68 strains of Enterobacter agglomerans were tested in microdilution procedures against N-formimidoyl thienamycin, ceftazidime, cefotiam, ceftriaxone and cefotaxime. N-formimidoyl thienamycin was the most effective drug as far as the spectrum of these bacterial groups and potency is concerned; ceftazidime was the second most effective agent. Ceftriaxone and cefotaxime were similar in their activity (against a smaller spectrum), while cefotiam showed little effect. There were occasional differences between MBC and MIC values which were most notable with ceftazidime, cefotiam, ceftriaxone and cefotaxime against E. agglomerans.

Three cases of human tissue lesions which yielded halophilic Vibrio species are reported. In the first one, V. alginolyticus was isolated from the drainage in an otitis media. In the second case, an ornithine-negative Vibrio species was the only isolate from a gallbladder gangrene. In the third case, V. parahaemolyticus was isolated together with six other potential pathogens from a leg injury sustained in an airplane crash. The bacteriology and differential diagnosis of the isolates is described. The results of some sensitivity tests varied with the salt content of the medium. The V. parahaemolyticus and V. alginolyticus strains were more likely seaborne; the origin of the Vibrio sp. strain remained obscure. The pathogenic properties of the V. parahaemolyticus strain appear somewhat doubtful.