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Biomedical subjects

S A Berger

Publications and source records attributed to S A Berger.

At least 19 recordsLinked to original sources

Site-directed mutagenesis identifies catalytic residues in the active site of Escherichia coli phosphofructokinase.

Six active site mutants of Escherichia coli phosphofructokinase have been constructed and characterized using steady-state kinetics. All but one of the mutants (ES222) have significantly lower maximal activity, implicating these residues in the catalytic process. Replacement of Asp127, the key catalytic residue in the forward reaction with Glu, results in an enzyme with wild-type cooperative and allosteric behavior but severely decreased Fru6P binding. Replacement of the same residue with Tyr abolishes cooperativity while retaining sensitivity to allosteric inhibition and activation. Thus, this mutant has uncoupled homotropic from heterotropic allostery. Mutation of Asp103 to Ala results in an enzyme which retains wild-type Fru6P-binding characteristics with reduced activity. GDP, which allosterically activates the wild-type enzyme, acts as a mixed inhibitor for this mutant. Mutation of Thr125 to Ala and Asp129 to Ser produces mutants with impaired Fru6P binding and decreased cooperativity. In the presence of the activator GDP, both these mutants display apparent negative cooperativity. In addition, ATP binding is now allosterically altered by GDP. These results extend the number of active site residues known to participate in the catalytic process and help to define the mechanisms behind catalysis and homotropic and heterotropic allostery.

Adenosine Triphosphate

Penetration of ceftriaxone and cefoperazone into bile and gallbladder tissue in patients with acute cholecystitis.

The penetration of ceftriaxone and cefoperazone into bile and gallbladder tissue was prospectively studied in 21 adult patients undergoing early surgery for acute cholecystitis. Comparable tissue, bile, and serum concentrations of the drugs were demonstrable; however, significantly fewer preoperative doses of ceftriaxone were required for adequate perioperative treatment. In view of its higher serum half-life and superior antibacterial activity toward common biliary pathogens, ceftriaxone appears to be a useful drug for the perioperative management of acute cholecystitis.

Acute Disease

Fatal necrotizing esophagitis due to Penicillium chrysogenum in a patient with acquired immunodeficiency syndrome.

Although blue-green molds of the genus Penicillium are ubiquitous in the human environment, invasive penicilliosis is uncommon and primarily encountered among immunosuppressed patients. A patient with HIV infection who died of severe necrotizing esophagitis caused by Penicillium chrysogenum is reported and the relevant English language literature on human penicilliosis is reviewed. Although infectious esophagitis is commonly associated with AIDS, Penicillium esophagitis has not been described in such patients.

AIDS-Related Opportunistic Infections

Coulter counter identifies Cryptococcus neoformans as leukocytes. A case of pseudopleocytosis.

Cerebrospinal fluid from a 42-year-old man with acquired immune deficiency syndrome was processed in a Coulter S-plus counter and found to contain "4.8 x 10(9) leukocytes/L:56.1% granulocytes and 37.7% lymphocytes." Direct examination of the same specimen in a counting chamber revealed that the leukocytes were cells of Cryptococcus neoformans. Coulter analysis of cerebrospinal fluid may be inappropriate, particularly when yeast infection is a probable diagnosis.

Acquired Immunodeficiency Syndrome

Initial testing of a novel urine culture device.

The Diaslide urine culture device consists of a hinged case containing two opposing agar media separated by a sampler with a handle at one end and two bent sampler tips at the opposite end. The tips of the sampler are first dipped into the urine. The sampler is then pulled out through the casing, simultaneously inoculating both agar surfaces with a streaking dilution. As a result, individual colonies can be observed even when bacterial concentrations exceed 10(6) CFU/ml. The number of colonies on the Diaslide correlated linearly with CFU per milliliter as determined by dilution plating. The clinical performance of the Diaslide was compared with those of ordinary dipslides and conventional cultures with a sample of 473 prescreened hospital urine specimens. The sensitivity, specificity, and positive predictive value of Diaslide versus those of culture at the 10(4)-CFU/ml cutoff level were 97.5, 98.3, and 98.3%, respectively, compared with 98.8, 95.7, and 97.2%, respectively, for dipslide versus culture. Similar results were found at the 10(5)-CFU/ml cutoff level. Only 5.5% of the Diaslides required subculturing, compared with 14.7 and 9.4% of the dipslides and conventional cultures, respectively. The Diaslide proved more convenient than an ordinary dipslide for sampling low volumes of urine. These data suggest that the Diaslide is a simple, effective device for culturing of urine specimens.

Bacteria

Steady-state fluorescence of Escherichia coli phosphofructokinase reveals a regulatory role for ATP.

We have investigated the effects of ligands and effectors on the intrinsic fluorescence of Escherichia coli phosphofructokinase (PFK). We have found that the substrate fructose 6-phosphate (Fru6P) or the allosteric activator ADP can quench the fluorescence up to 35%. The response is hyperbolic with Ks[Fru6P] of 20 microM and Ks[ADP] of 13 microM. The allosteric inhibitor phosphoenolpyruvate (PEP) converts the hyperbolic response with respect to Fru6P to a sigmoidal response. AMP-PNP, a nonhydrolyzable analogue of ATP, also inhibits the Fru6P fluorescence response. PFK mutant KA213, which is insensitive to effectors, has a decreased fluorescence response with respect to ADP, and PEP does not convert the Fru6P response to sigmoidicity. However, its fluorescence response with respect to Fru6P is decreased by ATP or AMP-PNP. Taken together, these results suggest that, in the absence of effectors or ligands, E. coli PFK exists in a state with high affinity for Fru6P ("R" state). This state can be altered to a low affinity ("T" state) by PEP binding to the allosteric site or by ATP binding to the enzyme.

Adenosine Diphosphate

Penetration of ofloxacin into human lung tissue following a single oral dose of 200 milligrams.

The penetration of ofloxacin into lung tissue was studied in 10 patients subjected to pulmonary surgery. Samples of blood and lung tissue were obtained 3 to 8 h (mean, 5 h) after oral administration of 200 mg. The mean level in tissue was 2.17 +/- 0.5 micrograms/g, while the mean level in serum was 0.85 +/- 0.23 micrograms/ml. The mean lung tissue/serum concentration ratio was 2.55 +/- 0.30. The achievable levels of ofloxacin in lung tissue are above the MICs for most pulmonary pathogens.

Administration, Oral

Active-site mutants altering the cooperativity of E. coli phosphofructokinase.

Crystal structures of the high- and low-activity states of the allosteric enzyme phosphofructokinase implicate three arginines in substrate binding, catalysis and cooperativity. Arginines 162 and 243 reach into the active site from an adjacent subunit and interact with the cooperative substrate fructose 6-phosphate. Mutation of these arginines to serine results in mutant enzymes with reduced substrate binding and lowered cooperativity, but with little change in their catalytic ability (kcat). Arg 72 bridges the two substrates fructose 6-phosphate and ATP, and interacts with the 1-phosphate of the product fructose 1,6-biphosphate. Mutation of this residue to serine reduces the catalytic activity, cooperativity and binding of fructose 6-phosphate and fructose 1,6-bisphosphate. In the reverse reaction, the kinetics of wild-type and the Ser 72 mutant with respect to fructose 1,6-bisphosphate are hyperbolic, whereas those of the Ser 162 and Ser 243 mutants are sigmoidal. These results show that each of the three arginines contributes to cooperativity and to the transmission of allosteric signals between the four subunit of the enzyme.

Adenosine Triphosphate

Concentration of ofloxacin and ciprofloxacin in human semen following a single oral dose.

A single oral dose of ofloxacin (400 mg.) or ciprofloxacin (500 mg.) was administered to each of 40 men. The mean concentrations of ofloxacin in semen exceeded those of ciprofloxacin at 1 hour (p = 0.035) and 24 hours (p = 0.028), while the levels of the 2 drugs at 2 and 4 hours were comparable. Semen concentrations of ofloxacin but not ciprofloxacin exceeded the reported minimal inhibitory concentration of Enterobacteriaceae, Chlamydia trachomatis and genital Mycoplasma species 24 hours after dosage.

Administration, Oral

Lack of precision in commercial identification systems: correction using Bayesian analysis.

Commercial microbial identification systems rank the relative likelihood of species identity on the basis of in vitro reactions only. Failure to consider the prevalence of individual taxa results in a spurious demotion of common species; and a tendency toward over reporting of rare microbes. The incorporation of Bayesian analysis into identification matrices can provide for a realistic ranking of bacterial species which fulfil given biocode schemes.

Bacteria

Penetration of clindamycin, cefoxitin, and metronidazole into pelvic peritoneal fluid of women undergoing diagnostic laparoscopy.

A single dose of clindamycin, cefoxitin, or metronidazole was administered to each of 30 women. The mean concentration of cefoxitin in pelvic fluid at 1 h exceeded those of the other two drugs (P less than 0.007). Cefoxitin concentrations were inferior to those of the other drugs when compared with the published MIC for 90% of Bacteroides fragilis strains.

Adult

Cross resistance to ciprofloxacin and other antimicrobial agents among clinical isolates of Acinetobacter calcoaceticus biovar anitratus.

Using an agar dilution assay, for 66 of 104 (63.5%) clinical isolates of Acinetobacter calcoaceticus biovar anitratus, the MIC of ciprofloxacin was greater than or equal to 1.0 micrograms/ml. Cross resistance was demonstrable to ciprofloxacin and gentamicin (P less than 0.001), amikacin (P less than 0.01), cefotaxime (P less than 0.001), azlocillin (P less than 0.001), ceftazidime (P less than 0.001), trimethoprim-sulfamethoxazole (P less than 0.001), and minocycline (P less than 0.05). The mean MIC of ciprofloxacin for drug-susceptible isolates was consistently lower than that for resistant isolates; however, these differences were significant only for amikacin (P = 0.036).

Acinetobacter

Vibrio cholerae bacteremia associated with gastrectomy.

Bacteremia due to Vibrio cholerae is rare. Each of 15 cases previously reported in the English language literature occurred in the setting of immune deficiency. We describe an instance of non-serogroup O1 V. cholerae septicemia in an otherwise healthy patient. Susceptibility to such infection may have been enhanced by a prior gastrectomy for duodenal ulcer.

Cholera

Rapid screening of urine for bacteria and cells by using a catalase reagent.

Five hundred urine samples were tested for cells and bacteria by using a commercial dipstick, a catalase screening device, standard culturing, and chamber counts. The sensitivities of the catalase test were 83% for all samples and 97.6% for specimens containing significant numbers of leukocytes and bacteria. The catalase screening test is simple to perform and should prove useful for the detection of urinary tract infections.

Bacteriuria

Penetration of aminoglycosides into human peritoneal tissue.

Each of 30 patients underwent elective laparotomy following administration of a single intravenous dose of amikacin, netilmicin or tobramycin. Therapeutic concentrations of amikacin were achieved in peritoneal tissue in 10/10 patients. Only 13/20 samples from patients receiving the other two antibiotics showed antibacterial activity. Our data suggest that the penetrability of tobramycin (53%) and amikacin (39%) into the uninflamed peritoneal tissue is superior to that of netilmicin (16%).

Amikacin