PubMed Health⌕ Search

Biomedical subjects

I S Snyder

Publications and source records attributed to I S Snyder.

At least 19 recordsLinked to original sources

Sterility of anesthetic and resuscitative drug syringes used in the obstetric operating room.

UNLABELLED: Because of the constant threat of emergent cesarean delivery, anesthetic induction and resuscitation drugs are often drawn into syringes and stored in the obstetric operating room (OR). This study investigated the potential for bacterial and fungal contamination of six drugs (thiopental, succinylcholine, ephedrine, atropine, lidocaine, and oxytocin) often prepared in the obstetric OR. A total of 756 drug syringes were prepared and stored in the obstetric OR for 8 days using normal clinical practices. Starting on Day 0, and subsequently on Days 4 and 8 of the experiment, 42 syringes of each drug were randomly selected from the pool, filtered through a 0.45-microm porosity sterile cellulose filter, and cultured on 5% sheep blood agar. Of the 756 syringes tested, none grew organisms of any type, which indicates a probability of drug sterility of > or = 0.9961 (95% confidence interval [CI]). The data from the cultures performed on syringes on Day 0 indicate a probability of initial contamination of < or = 0.018 (95% CI). This study demonstrates a high probability of sterility in drugs drawn into sterile syringes and stored at room temperature in an OR environment for up to 8 days. IMPLICATIONS: Drug syringes stored in emergency operating rooms are discarded after 24 h because of possible contamination. We searched for microorganisms in drug syringes stored in the operating room for up to 8 days. No microbes were detected using standard sterility testing techniques. Adopting longer storage periods could result in significant cost savings.

Anesthesia, Obstetrical↗

Migration and chemiluminescence of polymorphonuclear cells and monocytes to Bacteroides sonicates.

Recent investigations have demonstrated that various preparations obtained from representatives of the genus Bacteroides are poorly phagocytized by polymorphonuclear cells (PMN) and macrophages. Crude cell sonicates derived from Bacteroides have been examined for their ability to inhibit migration of PMN and monocytes using a modified migration under agarose in vitro assay. B. gingivalis and B. intermedius were found to be inhibitors of such migration while B. asaccharolyticus did not share this property (P less than 0.005). In addition, B. intermedius sonicates were found to inhibit PMN chemiluminescence to known stimulants (P less than 0.001). These data were not found to result from direct sonicate cytotoxicity and therefore lend additional support to the etiologic importance of specific Bacteroides strains in the pathogenesis of acute and chronic dentoalveolar infections.

Bacteroides↗

Characterization of monoclonal antibodies against the Escherichia coli hemolysin.

Twelve monoclonal antibodies (MAbs) produced against the Escherichia coli hemolysin (HlyA) encoded by the hemolysin recombinant plasmid pWAM04 were studied. HlyA derivatives from recombinant strains with different plasmids encoding HlyA amino-terminal and carboxy-terminal truncates, HlyA in-frame deletions, and HlyA frameshift mutations were used in immunoblots to localize the antigenic determinants for the anti-HlyA MAbs. The mapping of the MAb epitopes was also facilitated by immunoblotting analysis of HlyA polypeptide fragments derived by cyanogen bromide cleavage. The HlyA epitopes for 11 of the MAbs were mapped to relatively small linear regions of the cytolysin ranging from 28 to 160 amino acids. Five of the MAbs (C10, G8, E2, B7, and D12) neutralized HlyA hemolytic activity to varying degrees. The epitopes for these neutralizing MAbs were found to reside within the following HlyA regions: C10 and G8, amino acids 2 to 160; E2, amino acids 161 to 194; B7, amino acids 518 to 598; and D12, amino acids 626 to 726. Hemolytically active HlyA was dependent on the action of the hlyC gene product. The D12 MAb recognized only HlyA produced by strains with an intact hlyC function. MAb A10 recognized an epitope within the HlyA region from amino acids 728 to 829 where a glycine-rich repeat domain exists; however, this MAb did not neutralize HlyA hemolytic activity. A HlyA domain map showing the anti-HlyA epitope location was constructed.

Animals↗

Calcium is required for binding of Escherichia coli hemolysin (HlyA) to erythrocyte membranes.

The calcium requirement for hemolytic activity of Escherichia coli hemolysin was investigated by using hemolytic assays and immunoblotting of toxin-treated erythrocytes. The hemolytic activity of cell culture supernatants obtained during growth of E. coli in Luria-Bertani (LB) broth or calcium-free LB broth was calcium dependent. The hemolytic activity of culture supernatants obtained during growth in LB broth supplemented with calcium was calcium independent. Osmotic protection experiments using Dextran 4 to prevent cell lysis indicated that calcium was required for the binding of hemolysin to erythrocytes at both 4 and 37 degrees C. The binding efficiency at 4 degrees C was 50% of that occurring at 37 degrees C. The calcium-dependent binding was confirmed by immunoblotting saline-washed, toxin-treated erythrocytes with a monoclonal antibody after sodium dodecyl sulfate-polyacrylamide gel electrophoresis separation of membrane proteins. Bound hemolysin increased the calcium permeability of the cell membranes as evidenced by calcium-induced membrane protein alterations. The alterations in membrane proteins did not directly cause lysis of the cells. The results were consistent with a mechanism of lysis involving the formation of cation-selective pores in the membranes of target cells.

Animals↗

Domains of Escherichia coli hemolysin (HlyA) involved in binding of calcium and erythrocyte membranes.

The primary structure of Escherichia coli hemolysin (HlyA) contains a 9-amino-acid sequence which is tandemly repeated 13 times near the C terminus and which is essential for hemolytic activity. Hemolysin also requires an unknown modification by an accessory protein, HlyC, for hemolytic activity. The role of calcium in the interaction of HlyA with erythrocytes was investigated by using recombinant strains which produced inactive hemolysins unmodified by HlyC or deleted of the repeat sequences. 45Ca2+ autoradiography of the recombinant hemolysins separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and transferred to nitrocellulose showed that full-length, active hemolysin bound calcium. The domain involved in binding calcium was identified as the tandemly repeated sequences, since the deletion derivative missing 11 of the 13 repeats did not bind calcium. Inactive hemolysin, unmodified by HlyC, contained the repeated sequences and bound calcium as efficiently as the active, full-length toxin. The binding of the inactive toxins to erythrocytes was investigated by immunoblotting saline-washed, toxin-treated cells with monoclonal antibodies after sodium dodecyl sulfate-polyacrylamide gel electrophoresis separation of membrane proteins. The binding of full-length, active hemolysin to erythrocytes was calcium dependent. Inactive hemolysin deleted of the repeat units did not bind to cells. The inactive hemolysin, unmodified by HlyC, bound calcium but did not bind to erythrocytes. These results highlight the importance of calcium in the binding of hemolysin to erythrocytes and suggest that the binding of hemolysin to cells requires an interaction between the calcium-binding repeat domain and the modification produced by the HlyC protein.

Animals↗

Immune response to Escherichia coli alpha-hemolysin in patients.

The serum antibody response of patients infected with alpha-hemolysin (AH)-producing Escherichia coli was measured by three immunoassays: tube neutralization, microneutralization, and enzyme-linked immunosorbent assay. All three assay results showed good correlation with each other. The mean anti-AH titer in patients with E. coli infection was higher than the mean titer in noninfected patients. The hemolysin-neutralizing activity was immunoglobulin G. The amount of lipopolysaccharide (LPS) antibody did not correlate with the amount of AH antibody. LPS antibody measured by enzyme-linked immunosorbent assay was predominantly of the immunoglobulin G class. Adsorption of LPS antibody by E. coli H79 LPS did not affect anti-AH titers, indicating that LPS and AH have different antigenic determinants. AHs prepared from several different E. coli strains had identical or similar antigenic determinants at the active site. Hemolysin proteins separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis were stained identically by human sera with AH antibody and by a mouse monoclonal AH antibody.

Aged↗

Composition of affinity-purified alpha-hemolysin of Escherichia coli.

Escherichia coli alpha-hemolysin was purified from culture supernatants by affinity chromatography, using a hemolysis-neutralizing monoclonal antibody ligand. Purified hemolysin contains several proteins and lipopolysaccharides. Thus, alpha-hemolysin exists as a macromolecular complex and may be exported from E. coli cells by outer membrane fragmentation.

Antibodies, Monoclonal↗

Stimulation of human PMNs in vitro by a succinimide molecular complex of methylfurylbutyrolactone.

The immunopotentiating effects on human neutrophils of a new synthetic immune biological response modifer were studied. The compound is a succinimide crystalline molecular complex of methylfurylbutyrolactone (MFBL). The MFBL succinimide (MFBL-S) derivative was tested for its in vitro effects on polymorphonuclear leukocyte (PMN) functions. At microgram quantities, MFBL-S stimulated a twofold increase in: directed migration of PMNs; adherence to nylon; and uptake of E. coli lipopolysaccharide. The MFBL-S enhanced phagocytosis by PMNs of S. epidermidis and E. coli. Additionally, intracellular killing of S. epidermidis by MFBL-S treated PMNs was significantly increased at all doses studied, whereas killing of E. coli was only significantly different from controls at concentrations of 10 micrograms/ml.

Aldehydes↗

Chemical and immunological analysis of the complex structure of Escherichia coli alpha-hemolysin.

Escherichia coli alpha-hemolysin (AH) purified from culture supernatants by gel filtration and ion-exchange chromatography was heterogeneous in charge and size. A 107,000-dalton protein was identified as the product of the hlyA gene by its reactivity with anti-AH monoclonal antibodies. Proteolysis of the product of the hlyA gene occurred but was not required for transport of the protein through the cell wall. Active AH had a larger size and lower pI than analysis of the hlyA gene sequence would predict, thus suggesting that the hlyA protein is complexed with other bacterial products. Lipopolysaccharide was detected in purified hemolysin complex preparations and may be a major component of the complexes. These findings suggest several possible mechanisms for release of AH from the bacterial cell including release by outer membrane fragmentation. The existence of AH complexed with lipopolysaccharide may have important implications in understanding its toxicity.

Animals↗

Prevalence of Legionella-specific IgG and IgM antibody in a dental clinic population.

This study was undertaken to determine the frequency of Legionella infection in a dental clinic setting. Serum samples from 270 dental clinic personnel were evaluated using an enzyme-linked immunosorbent assay to detect Legionella-specific IgM and IgG antibodies. The pooled-species whole-cell-antigen preparation used in these assays was derived from six Legionella pneumophila strains and one strain each from Legionella bozemanii and Legionella micdadei. Significant levels of IgG and IgM antibodies were found in 20% and 16%, respectively, of the samples. This compares with 8% and 10%, respectively, for a randomly selected non-clinical group from the region (P less than 0.005). Samples from clinic personnel with significant IgG titers (greater than 1:128) were also evaluated for activity to each of the eight single-species antigens, with the following results: L. pneumophila, 45% (combined six strains); L. micdadei, 37%; and L. bozemanii, 18%. Comparing individuals' "years spent in the clinic environment" with the incidence of significant antibody levels strongly suggests that the risk of Legionella infection increases proportionately with increased clinic exposure time (P less than 0.05). Analysis of these data implies that Legionella may be present in the dental clinic environment, thus creating an increased risk for clinical personnel or patients.

Adolescent↗

Cyanobacterial stimulation of growth and oxygen uptake by Legionella pneumophila.

A laboratory-adapted strain of Legionella pneumophila grew in coculture with Fischerella. Insoluble Fischerella slime contained carbohydrate and protein and was isolated from cultures on filters. Slime-free filtrates separated into three 280-nm absorbance peaks on Sephadex G-25. Peaks 1 and 2 contained protein and carbohydrate and stimulated Legionella respiration. Peak 3 and slime had no effect.

Carbohydrates↗

Effect of Micropolyspora faeni cells and cell wall fractions on rabbit alveolar macrophages.

The reactivity of alveolar macrophages (AM) to cells and cell wall fractions (CWF) of Micropolyspora faeni was investigated. Exposure of cultured AM to M. faeni and its CWF caused the AM to form clumps or aggregates which remained attached to the culture dish surface. Other gram-positive and gram-negative bacteria as well as yeast, zymosan, latex microspheres, and isolated peptidoglycan from Listeria monocytogenes did not cause this response. The response was independent of species source and antibody content of the serum used in culture. The use of heat-inactivated sera negated the role of complement activation in the aggregation of AM. AM cultures required a period of culture before exposure to cells or CWF for this response to occur. This response was both time and dose dependent. Rabbit peritoneal macrophages also exhibited the clumping response. Degradation of a purified CWF, fraction 3, with lysozyme greatly diminished the clumping response. Chemical purification of fraction 3 with periodate, formamide, or trichloracetic acid also decreased this activity. These data suggest that the major active component causing this response is peptidoglycan but that other materials associated with the cell wall may also be important. A soluble-factor chemotactic for normal rabbit AM was found in the culture fluid of AM exposed to fraction 3. M. faeni cells and CWF also caused normal rabbit AM to chemiluminesce.

Animals↗

Characterization of surfaces involved in adherence of Legionella pneumophila to Fischerella species.

Legionella pneumophila adheres to the slime coat of Fischerella spp. This was shown by microscopic examination and by a decline in L. pneumophila CFU in samples removed from coincubation mixtures of both organisms. Binding of partially purified Fischerella slime by L. pneumophila was most efficient by young, less hydrophobic L. pneumophila cells than by older, more hydrophobic cells. Uptake of crystal violet and partitioning into hexadecane were used to measure hydrophobicity of L. pneumophila. Purified soluble Legionella antigen also bound to Fischerella slime, as shown by indirect immunofluorescence. Adherence was not specific for L. pneumophila, since a variety of gram-negative, gram-positive, and acid-fast bacteria also bound to Fischerella slime.

Adhesiveness↗

Cytotoxic activity of partially purified Escherichia coli alpha haemolysin.

Alpha haemolysin, produced by Escherichia coli, grown in a chemically defined medium, was purified 19-fold and the endotoxin content reduced 2176-fold by ultrafiltration and glycerol-gradient ultracentrifugation. Immunodiffusion of purified alpha haemolysin (PH) against antiserum to crude haemolysin (CH) revealed only one precipitation line. PH was cytotoxic in nanogram amounts for mouse-fibroblast 3T3 cells, and the cytotoxicity exhibited proportional dose-response and time-course kinetics. The cytotoxic and haemolytic activities of PH were neutralised by immunoglobulins to CH. A mutant, produced by treating the haemolytic wild type with mitomycin C, possessed all of the biochemical characteristics of the wild type with the exception that the extracellular products of the mutant were non-haemolytic and non-cytotoxic.

Animals↗

Effect of Escherichia coli alpha-hemolysin on human peripheral leukocyte viability in vitro.

To gain further evidence that Escherichia coli alpha-hemolysin has a role in pathogenesis, its effect on human peripheral leukocyte viability was studied in vitro. Viability of leukocytes exposed to low doses of alpha-hemolysin decreased nearly 10-fold within 15 min of exposure. This response was dose and time dependent and was neutralized by antiserum, heat, proteases, and lipase. To gain further evidence that alpha-hemolysin was the molecule responsible for leukotoxicity, preparations of alpha-hemolysin were passed through a hydrophobic interaction chromatographic column. Alpha-hemolysin prepared in this way retained its leukotoxic activity. Both hemolytic and leukotoxic activities copurified at the same ratio and were inactivated to the same degree by heating at 56 degrees C. Lysis of leukocytes, if it occurs in vivo, would enhance the chances of survival for an invading hemolytic E. coli.

Cell Survival↗

Effect of Escherichia coli alpha-hemolysin on human peripheral leukocyte function in vitro.

To gain further evidence for the role of the Escherichia coli alpha-hemolysin in pathogenesis, its in vitro effects on human peripheral leukocyte function were studied. Leukocytes exposed to low doses of alpha-hemolysin responded with a marked chemiluminescence response, indicating activation of oxidative metabolism. This response was time and dose dependent. Pretreatment of leukocytes with doses of alpha-hemolysin at which nearly 80% of the cells survived decreased the ability of the cells to phagocytize bacteria and particles and to undergo chemotaxis. Premature activation of leukocytes and inhibition of phagocytosis and chemotaxis by alpha-hemolysin, if they occur in vivo, would greatly enhance the survival of an invading E. coli strain.

Chemotaxis, Leukocyte↗