Scanning electron microscopy of morphological alterations in Proteus mirabilis induced by cephalosporins and semisynthetic penicillins

Mechanisms of interaction among subinhibitory concentrations of antibiotics, human polymorphonuclear neutrophils, and gram-negative bacilli

Our hypothesis was that pretreatment of bacteria with subinhibitory concentrations (sub-MICs) of antibiotics enhances the susceptibility of the organisms to killing by human polymorphonuclear neutrophils (PMNs). Our purpose was to study a variety of drugs with different mechanisms of action and to determine whether the mechanism and locus of action altered the sub-MIC effect. The following outcome measures were used: ingestion and killing of bacteria by PMNs, bacterial killing in the absence of phagosome formation, and binding requirements of the bacteria to PMNs. The antibiotics used were representative of a variety of classes, including beta-lactams (piperacillin and imipenem) and quinolones (ciprofloxacin). Bacterial uptake and killing were measured by using standard techniques, and results were analyzed by using the analysis-of-variance technique and Dunnett's t test. Pretreatment of Escherichia coli with all drugs showed significantly enhanced killing of bacteria by PMNs, which was independent of ingestion by the phagocytes. Even in the absence of phagosome formation, statistically significant killing persisted with piperacillin-pretreated bacteria but not with imipenem- or ciprofloxacin-pretreated organisms. The opsonization experiments showed that contact between bacteria and PMNs was necessary for killing to occur. The sub-MIC effect appears to be independent of the locus or mechanism of action of the antibiotic. It results in enhanced killing by PMNs which is independent of ingestion and also may persist even in the absence of phagosome formation. Killing is dependent upon specific contact between bacteria and an intact phagocyte.

Side effects of antibiotics on immune response parameters and their possible implications in antimicrobial chemotherapy

Antibiotics may influence immune response by quite different ways. By screening the multitude of publications on this subject, the aim of this overview was to arrive at a basic generalizing statement on the relationship between chemical structure or mode of action of antibiotics and the effect on immune response and to get an indication on whether certain in vitro and/or ex vivo parameters could represent comparable effects under clinical conditions. - The influence of antibiotics on immune response may arise by direct effects on immunocompetent cells, i.e. in the absence of microorganisms, or indirectly by changes in structure or metabolic products of germs induced by subminimal inhibitory concentrations (subMIC's). In the former case, stimulatory and inhibitory effects have been observed on phagocytosis and intracellular killing activity, on antibody production including IgE, on different parameters of cellular immunity (e.g. foodpad swelling reaction, MIF-production, mitogen/antigen induced lymphocyte proliferation and delayed type hypersensitivity skin reaction), on mediator production as interleukins or prostaglandins and the expression of corresponding receptors on immunocompetent cells as well as on the course of experimental infections with primary resistant microorganisms. - Indirect effects are related to the influence of subMIC's of antibiotics on the morphology and structure of microorganisms, on their antigenicity/immunogenicity or on their serosensitivity and enzyme and toxin production. - This overview shows that - according to the actual knowledge - antibiotics may exhibit immunological side effects which, however, can not strictly be attributed to certain chemical structures or to a certain mode of action. - It has to be considered that a literary study comparing the results of different authors is rendered difficult by the often nonhomogeneity of experimental procedures and the fact that little is known yet about immunological side effects of antibiotics in man, i.e. under clinical conditions.

Comparative activity of N-formimidoyl thienamycin with third generation cephalosporins and ureido penicillins against multiple resistant Serratia marcescens

Twenty multiple resistant clinical isolates were tested with N-formimidoyl thienamycin, moxalactam, cefotaxime, cefoperazone, and the three ureidopenicillins: azlocillin, mezlocillin, and piperacillin. A concentration of less than 0.97 microgram/ml inhibited 100% of organisms for N-f-thienamycin and cefotaxime, 90% for moxalactam, and 60% for cefoperazone. An increase in inoculum from 10(3) to 10(6) cells reduced activity fourfold for 95% of isolates with cefoperazone, 70% with N-formimidoyl thienamycin, 65% for cefotaxime, but only 15% for moxalactam. For ureidopenicillins, 85% of strains tested had MIC's less than or equal to 15.6 micrograms/ml. An inoculum effect was observed in only 35-50%. At 10(3), the cidal concentration was the same or twofold greater than the inhibitory level for N-f-thienamycin and cephalosporins in 70% of strains tested and 65% for penicillins. With 10(6), the 70% value remained for N-f-thienamycin but was reduced to 45% for cefotaxime and 25% for moxalactam; 85% demonstrated greater than eightfold differences with cefoperazone. Single step high-level resistance was observed to moxalactam (20%). Carbenicillin resistant strains were cross-resistant to the ureidopenicillins. N-f-thienamycin and cefotaxime appeared comparable, although important differences between morphological alteration and metabolism may influence their therapeutic effectiveness.

Effects of subinhibitory concentrations of antibiotics on cross walls of cocci

Cultures of Staphylococcus aureus, Neisseria gonorrhoeae, and Streptococcus bovis were incubated on membrane filters on agar containing antibiotics at one-third to one-fourth the minimal inhibitory concentration for the particular bacterial strain. S. aureus was grown in the presence of oxacillin, cephaloridine, or lincomycin. N. gonorrhoeae and S. bovis were grown in the presence of penicillin. The membranes were then incubated in drug-free agar, after which viability was determined and the cells were examined by electron microscopy. S. aureus exposed to oxacillin and cephaloridine grew into cells two to seven times larger than normal that contained thick multiple cross walls. S. aureus exposed to lincomycin grew into cells 1.5 to 2 times larger than normal, with multiple thick cross walls and periheral cell walls twice the normal thickness. N. gonorrhoeae cells exposed to penicillin were slightly larger than normal and had cross walls that were up to eight times thicker than normal. After transfer to drug-free agar, cells became smaller, and some normal organisms could be seen. S. bovis incubated in the presence of penicillin grew into filaments that contained no cross walls. Two hours after the return to drug-free agar, filaments with cross walls as well as normal cells were observed. Exposure to subinhibitory concentrations of penicillin did not affect the growth of the peripheral cell wall of S. aureus, N. gonorrhoeae, or S. bovis, but appeared to inhibit lysis of cross walls in S. aureus and N. gonorrhoeae and to inhibit the synthesis of cross walls in S. bovis; that is, the rates of peripheral and cross wall formation differed in their susceptibility to penicillin. These facts suggest that peripheral growth and cross wall formation in cocci are separable processes.

Evaluation of antibiotic efficacy using electron microscopy: morphological effects of guanylureido cephalosporin, chlorobenzoylureido cephalosporin, BL-P1654, and carbenicillin on Pseudomonas aeruginosa

The response of Pseudomonas aeruginosa to carbenicillin, BL-P1654, and two cephalosporins (112384 and 112883) was evaluated by minimal inhibitory concentration determinations, [(14)C]leucine uptake studies, morphological studies of colonial growth, and mouse intraperitoneal inoculations. Spheroplast formation and bacterial lysis were not the early response; instead, cell division was inhibited and long filaments were formed. Spheroplast formation and bacterial lysis were not observed in the first 7 h of incubation in minimal inhibitory concentrations of antibiotic.

Relative morphological effects induced by cefoxitin and other beta-lactam antibiotics in vitro

Cefoxitin, a new semisynthetic cephamycin antibiotic, induced filament formation at subinhibitory concentrations with a beta-lactamaseless strain of Enterobacter cloacae (HSC 18410 M66). The extent of filament induction by cefoxitin was similar to that seen with cephalothin, cefazolin, and benzylpenicillin. Filament induction by cefoxitin was markedly less than that seen with cephalexin, carbenicillin, ticarcillin, cephradine, and cephapirin. Antibiotics which failed to induce filaments at any level tested included cephaloridine, cephacetrile, cephalosporin C, the cephamycins, 6-aminopenicillanic acid, 7-aminocephalosporanic acid, A16884, A16886, and FL-1060. Those antimicrobial agents tested which lacked an aromatic substituent in the 7-position (for cephems) or in the 6-position (for penams) did not induce filaments. These observations suggest a possible relationship between filament induction of the test organism and the molecular nature of constituents in the 7- or 6-position of beta-lactams.

Septum formation in Escherichia coli: characterization of septal structure and the effects of antibiotics on cell division

Septa can be demonstrated in sections of Escherichia coli strains B and B/r after fixation with acrolein and glutaraldehyde. The septum consists of an ingrowth of the cytoplasmic membrane and the mucopeptide layer; the outer membrane is excluded from the septum until the cells begin to separate. Mesosomes have also been observed. The septum is highly labile and, except in the chain-forming strains, E. coli D22 env A and CRT 97, not easily preserved by standard procedures. The labile nature of the septum may be due to the presence of autolysin(s) located at the presumptive division site. Blocking division by addition of ampicillin (2 to 5 mug/ml) to cells of E. coli B/r produces a bulge at the middle of the cells; bulge formation is stopped by addition of chloramphenicol. Cephalosporins also induce bulge formation but may stop cell elongation as well as division. Bulge formation, due to the presumed action of an autolysin(s), may be an initial step in the septation sequence when the mucopeptide is modified to allow construction of the septum. In a nonseptate filament-forming strain, PAT 84, which ceases to divide at 42 C, bulge formation only occurs in the presence of ampicillin at the time of a shift-down at 30 C or at 42 C in the presence of NaCl (0.25 to 0.34 M). Experiments with chloramphenicol suggest that the filaments are fully compartmentalized but fail to divide owing to the inactivation, rather than loss of synthesis, of an autolysin at 42 C.